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. 2021 Jun 26;7(1):52.
doi: 10.1186/s40981-021-00455-7.

Macintosh laryngoscope and i-view™ and C-MAC® video laryngoscopes for tracheal intubation with an aerosol box: a randomized crossover manikin study

Toshiyuki Nakanishi  1 , Yoshiki Sento  2 , Yuji Kamimura  2 , Kazuya Sobue  2
Affiliations

Macintosh laryngoscope and i-view™ and C-MAC® video laryngoscopes for tracheal intubation with an aerosol box: a randomized crossover manikin study

Toshiyuki Nakanishi et al. JA Clin Rep. .

Abstract

Background: We tested the hypothesis that the C-MAC® video laryngoscope (C-MAC) with an external display is more useful than the disposable i-view™ video laryngoscope (i-view) with an integrated display or a Macintosh direct laryngoscope (Macintosh) for tracheal intubation with an aerosol box.

Methods: In this randomized, crossover manikin study, we recruited 37 medical personnel with > 2 years of dedicated anesthesia experience from five hospitals. After the three successful intubations within 60 s using each laryngoscope without a box, the participants performed tracheal intubation thrice with each laryngoscope with at least 2-h intervals in a determined order. The primary outcome was the intubation time. The secondary outcomes were success rate, Cormack-Lehane grade, and subjective difficulty scale score.

Results: Thirty-seven personnel (11 women and 26 men) with 12 [5-19] (median [interquartile range]) years of anesthesia and intensive care experience were enrolled. There was no significant difference in the intubation time: 30 [26-32] s for Macintosh, 29 [26-32] s for i-view, and 29 [25-31] s for C-MAC (P = 0.247). The success rate was 95-100%, without a significant difference (P = 0.135). The i-view and C-MAC exhibited superior Cormack-Lehane grades and lower subjective difficulty scale scores than the Macintosh; however, there were no differences between the i-view and C-MAC.

Conclusions: Rapid and highly successful tracheal intubation was possible with both Macintosh, i-view, and C-MAC on a normal airway manikin in an aerosol box. Improved Cormack-Lehane grade and the ease of performing the procedure may support the use of video laryngoscopes.

Trial registration: UMIN Clinical Trials Registry, UMIN000040269 . Registered 30 April 2020.

Keywords: Aerosol box; Airway management; COVID-19; Laryngoscope; Tracheal intubation; Video laryngoscope.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Macintosh, i-view, and C-MAC laryngoscope and visual images of tracheal intubation with an aerosol box. A Macintosh direct laryngoscope. B i-view video laryngoscope. C C-MAC video laryngoscope. D–F Laryngoscopic view of the glottis in each laryngoscope. G–I Lateral image during the tracheal intubation in each laryngoscope. The white arrows show the operator’s lines of sight
Fig. 2
Fig. 2
CONSORT diagram of the study participants
See this image and copyright information in PMC

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References

    1. Zuo MZ, Huang YG, Ma WH, Xue ZG, Zhang JQ, Gong YH, et al. Expert recommendations for tracheal intubation in critically ill patients with novel coronavirus disease 2019. Chin Med Sci J. 2020;35:105–109. - PMC - PubMed
    1. Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, Deshpande R, Zhang L, Meng J, Tong C, Liu H, Xiong L. Intubation and ventilation amid the COVID-19 outbreak: Wuhan’s experience. Anesthesiology. 2020;132(6):1317–1332. doi: 10.1097/ALN.0000000000003296. - DOI - PMC - PubMed
    1. Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth. 2020;67(5):568–576. doi: 10.1007/s12630-020-01591-x. - DOI - PMC - PubMed
    1. Sorbello M, El-Boghdadly K, Di Giacinto I, Cataldo R, Esposito C, Falcetta S, et al. The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice. Anaesthesia. 2020;75(6):724–732. doi: 10.1111/anae.15049. - DOI - PubMed
    1. Cook TM, El-Boghdadly K, McGuire B, McNarry AF, Patel A, Higgs A. Consensus guidelines for managing the airway in patients with COVID-19: guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists. Anaesthesia. 2020;75(6):785–799. doi: 10.1111/anae.15054. - DOI - PMC - PubMed

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