Intubation Clinical Trial
Official title:
A Prospective, Randomized, Single Center Study to Compare Endotracheal Tube Placement Using McGrath MAC® Video Laryngoscope Versus Macintosh Laryngoscope in Bariatric Surgery Patients
This study aims...
- To assess the difference in intubation difficulty scale (IDS) score following ETT
placement using McGrath MAC® video laryngoscope versus conventional intubation with
Macintosh laryngoscope for bariatric surgery patients
- To assess the difference in hemodynamic stimulation (airway manipulation) events in both
groups
- To assess the overall difference of the duration (seconds) of ETT placement between both
groups
- To assess the difference of the duration (seconds) of ETT placement during every attempt
(maximum of three attempts) between both groups.
- To assess the difference of STOP BANG score between both groups
- To assess the number of intubation attempts between both groups
The failure to place properly an endotracheal tube (ETT) and to secure the airway is still
significantly impacting morbidity and mortality in surgical and critical care settings. In
addition, no assertive predictor factor will foresee the presence of difficult airway, most
of them being acknowledged after anesthesia induction. The incidence of difficult intubation
reported in different studies varies from 0.1% to 13%.
The gold standard device to place an ETT that has been used since 1943 is the Macintosh
laryngoscope (ML). However, in contemplation of addressing these challenging factors related
to endotracheal intubation failure, modern airway devices technology has been developed in
order to improve orotracheal visualization, reduce orotracehal manipulation and ensure airway
patency.
As part of these novel devices, several video laryngoscopies (VL) have s been developed to
secure the airway and improve the management of difficult intubation. Difficult Airway
Society (DAS) guidelines recognizes the usefulness of VL in difficult intubation by providing
an improved view of the airway to clinicians and directly observe/report the effects of
laryngeal manipulation.
Among several VL introduced recently, a McGrath MAC® VL was announced in 2012. McGrath MAC®
is a self-contained VL with a single-use blade; its structure is similar to the ML, but
without the channel that guides the tube and a mounted LCD screen on the handle that is
connected to a miniature camera with a light source at the tip of the blade, allowing the
clinicians to directly observe surrounding anatomical airway structures during a tracheal
intubation. These features have shown a better glottis visualization and to be supportive
during tracheal intubation of difficult airways.
The McGrath MAC® VL and ML are standard of care devices used according to anesthesia care
providers' criteria at our institution.
A single-center, prospective, randomized, double arm study, will be conducted in order to
test the following hypothesis:
Reduced manipulation of the airway using McGrath MAC® VL will lead to less hemodynamic
stimulation events following intubation when compared to ML.
The non-disposable portion of the McGrath MAC® VL (upper mounted reusable video camera and
the optic guide) will be cleaned between usages in accordance to manufacture catalogue and
institutional policy (using disinfectants such as CIDEXTM OPA, a 0.08% paracetic acid
solution or disinfecting wipes).
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