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Randomized Controlled Trial
. 2019 Oct-Dec;22(4):365-371.
doi: 10.4103/aca.ACA_120_18.

Comparative evaluation of hemodynamic responses and ease of intubation with airtraq video laryngoscope versus macintosh laryngoscope in patients with ischemic heart disease

A V Varsha  1 , Gladdy George  2 , Rahul Pillai  2 , Raj Sahajanandan  2
Affiliations
Randomized Controlled Trial

Comparative evaluation of hemodynamic responses and ease of intubation with airtraq video laryngoscope versus macintosh laryngoscope in patients with ischemic heart disease

A V Varsha et al. Ann Card Anaesth. 2019 Oct-Dec.

Abstract

Introduction: Hemodynamic responses during laryngoscopy can potentially precipitate ischemia in patients with coronary artery disease. There are conflicting reports regarding the hemodynamic stress responses between the conventional Macintosh and video laryngoscopes. There is a paucity of studies regarding the same in cardiac surgical patients.

Materials and methods: A prospective, randomized control study to compare the hemodynamic responses and ease of intubation using Airtraq video laryngoscope and Macintosh laryngoscope in patients with ischemic heart disease.

Results: Seventy patients were randomized into two groups. Baseline variables including age, weight, Mallampati score, and comorbidities were comparable between the two groups. There was statistically significant elevation in mean heart rate in the Macintosh group at 2nd-min (P = 0.02) and 3rd-min (P = 0.05) postintubation. Similarly, there was a significant increase in mean arterial pressure at 2nd (P = 0.06), 3rd (P = 0.03), and 4th (P = 0.03) in the Macintosh group. The time for laryngoscopy and Intubation Difficulty Scale was significantly better in the Airtraq group (P = 0.001 and 0.001). However, the median time to intubation was longer in the Airtraq group (13 s vs. 11 s, P = 0.05). Laryngoscopy view was better with Airtraq even in patients with Mallampati score 3 (ten patients). The incidence of trauma was same in both the groups.

Conclusion: Airtraq provides the better hemodynamic stability and ease of intubation and may be considered superior to conventional Macintosh laryngoscope for intubation in patients with ischemic heart disease.

Keywords: Airtraq; Macintosh; hemodynamic response; ischemic heart disease.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Algorithm of the study
Figure 2
Figure 2
Graph representing and comparing the mean of (a) heart rate, (b) mean arterial pressure, (c) systolic blood pressure, and (d) diastolic blood pressure between the “Macintosh” and “Airtraq” groups during the time frames of the study (T1-T8)
Figure 3
Figure 3
Bar diagram comparing the mean percentage change in (a) heart rate and (b) mean arterial pressure between “Macintosh” and “Airtraq” groups after intubation (T4-T8)
Figure 4
Figure 4
Insertion of the endotracheal tube into the channel (a) Correct and (b) Incorrect
Figure 5
Figure 5
Glottic view and intubation using Airtraq (a and b), glottic view using smartphone app, (c) passing of endotracheal tube into the glottis
See this image and copyright information in PMC

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