Intubation in the Intensive Care Unit: C-MAC video laryngoscope versus Macintosh laryngoscope

Med Intensiva (Engl Ed). 2020 Apr;44(3):135-141. doi: 10.1016/j.medin.2019.10.004. Epub 2019 Nov 25.
[Article in English, Spanish]

Abstract

Purpose: Various modifications of the Macintosh blade and direct laryngoscopy have been incorporated into practice to improve the intubation success rate and avoid complications while ensuring patient safety. This study evaluates the usefulness of two different direct laryngoscopy methods used by operators with various level of experience in the Intensive Care Unit.

Material and methods: In a single centre prospective study, C-MAC and Macintosh laryngoscopes were compared in terms of laryngoscopy and intubation outcomes such as glottic visualization, number of intubation attempts, intubation success and satisfaction score.

Results: During the one-year study period, 263 patients were evaluated and data of 218 patients were analyzed. The rate of successful first attempt intubation was higher in the video laryngoscope group (VL) (84% vs 57%; P<0.001). A significantly greater number of patients in the Macintosh laryngoscopy group had difficult visualization of the glottis in terms of the modified Cormack and Lehane classification and Percentage of Glottic Opening scale.

Conclusion: The use of video laryngoscope for intubation in ICU settings results in better visualization of the glottis and a higher incidence of successful intubation attempts.

Keywords: Intubación; Intubation; Video laryngoscope; Videolaringoscopio; Visualización de la glotis; Visualization of the glottis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Anesthesiologists
  • Critical Care
  • Female
  • Glottis / anatomy & histology
  • Humans
  • Intensive Care Units*
  • Intubation, Intratracheal / instrumentation*
  • Intubation, Intratracheal / methods
  • Laryngoscopes*
  • Laryngoscopy / instrumentation*
  • Laryngoscopy / methods
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome