Time to intubation with McGrath™ videolaryngoscope versus direct laryngoscope in powered air-purifying respirator: a randomised controlled trial
Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, multiple guidelines have recommended videolaryngoscope (VL) for tracheal intubation. However, there is no evidence that VL reduces time to tracheal intubation, and this is important for COVID-19 patients with respiratory failure....
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| Format: | Article |
| Language: | English |
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Wolters Kluwer – Medknow Publications
2024-01-01
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| Series: | Singapore Medical Journal |
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| Online Access: | https://journals.lww.com/10.11622/smedj.2021165 |
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| author | Qing Yuan Goh Sui An Lie Zihui Tan Pei Yi Brenda Tan Shin Yi Ng Hairil Rizal Abdullah |
| author_facet | Qing Yuan Goh Sui An Lie Zihui Tan Pei Yi Brenda Tan Shin Yi Ng Hairil Rizal Abdullah |
| author_sort | Qing Yuan Goh |
| collection | DOAJ |
| description | Introduction:
During the coronavirus disease 2019 (COVID-19) pandemic, multiple guidelines have recommended videolaryngoscope (VL) for tracheal intubation. However, there is no evidence that VL reduces time to tracheal intubation, and this is important for COVID-19 patients with respiratory failure.
Methods:
To simulate intubation of COVID-19 patients, we randomly assigned 28 elective surgical patients to be intubated with either McGrath™ MAC VL or direct laryngoscope (DL) by specialist anaesthetists who donned 3M™ Jupiter™ powered air-purifying respirators (PAPR) and N95 masks. The primary outcome was time to intubation.
Results:
The median time to intubation was 61 s (interquartile range [IQR] 37–63 s) and 41.5 s (IQR 37–56 s) in the VL and DL groups, respectively (P = 0.35). The closest mean distance between the anaesthetist and patient during intubation was 21.6 ± 4.8 cm and 17.6 ± 5.3 cm in the VL and DL groups, respectively (P = 0.045). There were no significant differences in the median intubation difficulty scale scores, proportion of successful intubations at the first laryngoscopic attempt and proportion of intubations requiring adjuncts. All the patients underwent successful intubation with no adverse event.
Conclusion:
There was no significant difference in the time to intubation of elective surgical patients with either McGrath™ VL or DL by specialist anaesthetists who donned PAPR and N95 masks. The distance between the anaesthetist and patient was significantly greater with VL. When resources are limited or disrupted during a pandemic, DL could be a viable alternative to VL for specialist anaesthetists. |
| format | Article |
| id | doaj-art-4e203a766bc5405eb2c57668d7c82dd7 |
| institution | Kabale University |
| issn | 0037-5675 2737-5935 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer – Medknow Publications |
| record_format | Article |
| series | Singapore Medical Journal |
| spelling | doaj-art-4e203a766bc5405eb2c57668d7c82dd72025-02-09T10:19:06ZengWolters Kluwer – Medknow PublicationsSingapore Medical Journal0037-56752737-59352024-01-016512810.11622/smedj.2021165Time to intubation with McGrath™ videolaryngoscope versus direct laryngoscope in powered air-purifying respirator: a randomised controlled trialQing Yuan GohSui An LieZihui TanPei Yi Brenda TanShin Yi NgHairil Rizal AbdullahIntroduction: During the coronavirus disease 2019 (COVID-19) pandemic, multiple guidelines have recommended videolaryngoscope (VL) for tracheal intubation. However, there is no evidence that VL reduces time to tracheal intubation, and this is important for COVID-19 patients with respiratory failure. Methods: To simulate intubation of COVID-19 patients, we randomly assigned 28 elective surgical patients to be intubated with either McGrath™ MAC VL or direct laryngoscope (DL) by specialist anaesthetists who donned 3M™ Jupiter™ powered air-purifying respirators (PAPR) and N95 masks. The primary outcome was time to intubation. Results: The median time to intubation was 61 s (interquartile range [IQR] 37–63 s) and 41.5 s (IQR 37–56 s) in the VL and DL groups, respectively (P = 0.35). The closest mean distance between the anaesthetist and patient during intubation was 21.6 ± 4.8 cm and 17.6 ± 5.3 cm in the VL and DL groups, respectively (P = 0.045). There were no significant differences in the median intubation difficulty scale scores, proportion of successful intubations at the first laryngoscopic attempt and proportion of intubations requiring adjuncts. All the patients underwent successful intubation with no adverse event. Conclusion: There was no significant difference in the time to intubation of elective surgical patients with either McGrath™ VL or DL by specialist anaesthetists who donned PAPR and N95 masks. The distance between the anaesthetist and patient was significantly greater with VL. When resources are limited or disrupted during a pandemic, DL could be a viable alternative to VL for specialist anaesthetists.https://journals.lww.com/10.11622/smedj.2021165coronavirus disease 2019intubationpersonal protective equipmentpowered air-purifying respiratorvideolaryngoscope |
| spellingShingle | Qing Yuan Goh Sui An Lie Zihui Tan Pei Yi Brenda Tan Shin Yi Ng Hairil Rizal Abdullah Time to intubation with McGrath™ videolaryngoscope versus direct laryngoscope in powered air-purifying respirator: a randomised controlled trial Singapore Medical Journal coronavirus disease 2019 intubation personal protective equipment powered air-purifying respirator videolaryngoscope |
| title | Time to intubation with McGrath™ videolaryngoscope versus direct laryngoscope in powered air-purifying respirator: a randomised controlled trial |
| title_full | Time to intubation with McGrath™ videolaryngoscope versus direct laryngoscope in powered air-purifying respirator: a randomised controlled trial |
| title_fullStr | Time to intubation with McGrath™ videolaryngoscope versus direct laryngoscope in powered air-purifying respirator: a randomised controlled trial |
| title_full_unstemmed | Time to intubation with McGrath™ videolaryngoscope versus direct laryngoscope in powered air-purifying respirator: a randomised controlled trial |
| title_short | Time to intubation with McGrath™ videolaryngoscope versus direct laryngoscope in powered air-purifying respirator: a randomised controlled trial |
| title_sort | time to intubation with mcgrath™ videolaryngoscope versus direct laryngoscope in powered air purifying respirator a randomised controlled trial |
| topic | coronavirus disease 2019 intubation personal protective equipment powered air-purifying respirator videolaryngoscope |
| url | https://journals.lww.com/10.11622/smedj.2021165 |
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