Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
Annals of Intensive Care
Published in: Annals of Intensive Care 1/2021

01-12-2021 | Laryngoscopy | Research

Comparison of four channelled videolaryngoscopes to Macintosh laryngoscope for simulated intubation of critically ill patients: the randomized MACMAN2 trial

Authors: Paul Decamps, Nicolas Grillot, Aurelie Le Thuaut, Noelle Brule, Corinne Lejus-Bourdeau, Jean Reignier, Jean-Baptiste Lascarrou

Published in: Annals of Intensive Care | Issue 1/2021

Login to get access

Abstract

Background

Videolaryngoscopes with an operating channel may improve the intubation success rate in critically ill patients. We aimed to compare four channelled videolaryngoscopes to the Macintosh laryngoscope used for intubation of a high-fidelity simulation mannikin, in a scenario that simulated critical illness due to acute respiratory failure.

Results

Of the 79 residents who participated, 54 were considered inexperienced with orotracheal intubation. Each participant used all five devices in random order. The first-pass success rate was 97.5% [95% CI 91.1–99.7] for Airtraq™, KingVision™, and Pentax AWS200™, 92.4% [95% CI 84.2–97.2] for VividTrac VT-A100™, and 70.9% [95% CI 59.6–80.6] for direct Macintosh laryngoscopy. The first-pass success rate was significantly lower with direct Macintosh laryngoscopy than with the videolaryngoscopes (p  <  0.0001 for Airtraq™, KingVision™, Pentax AWS200™, and VividTrac VT-A100™).

Conclusion

The Airtraq™, KingVision™, and Pentax AWS200™ channelled videolaryngoscopes produced high first-pass success rates with a lower boundary of the 95% CI above 90%. A multicentre, randomised controlled clinical study comparing channelled videolaryngoscopy to direct laryngoscopy should include one of these three videolaryngoscopes.
Appendix
Available only for authorised users
Literature
1.
Heuer JF, Barwing TA, Barwing J, Russo SG, Bleckmann E, Quintel M, et al. Incidence of difficult intubation in intensive care patients: analysis of contributing factors. Anaesth Intensiv Care. 2012;40(1):120–7.CrossRef
2.
Jaber S, Jung B, Corne P, Sebbane M, Muller L, Chanques G, et al. An intervention to decrease complications related to endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Intensiv Care Med. 2010;36(2):248–55.CrossRef
3.
Russotto V, Myatra SN, Laffey JG, Tassistro E, Antolini L, Bauer P, et al. Intubation practices and adverse peri-intubation events in critically ill patients from 29 countries. JAMA. 2021;325(12):1164–72.PubMedCrossRefPubMedCentral
4.
De Jong A, Rolle A, Molinari N, Paugam-Burtz C, Constantin JM, Lefrant JY, et al. Cardiac arrest and mortality related to intubation procedure in critically ill adult patients: a multicenter cohort study. Crit Care Med. 2018;46(4):532–9.PubMedCrossRef
5.
Griesdale DE, Bosma TL, Kurth T, Isac G, Chittock DR. Complications of endotracheal intubation in the critically ill. Intensiv Care Med. 2008;34(10):1835–42.CrossRef
6.
Mort TC. Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts. Anesth Analg. 2004;99(2):607–13.PubMedCrossRef
7.
Sakles JC, Chiu S, Mosier J, Walker C, Stolz U. The importance of first pass success when performing orotracheal intubation in the emergency department. Acad Emerg Med. 2013;20(1):71–8.PubMedPubMedCentralCrossRef
8.
De Jong A, Molinari N, Terzi N, Mongardon N, Arnal JM, Guitton C, et al. Early identification of patients at risk for difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study. Am J Respir Crit Care Med. 2013;187(8):832–9.PubMedCrossRef
9.
Schwartz DE, Matthay MA, Cohen NH. Death and other complications of emergency airway management in critically ill adults. A prospective investigation of 297 tracheal intubations. Anesthesiology. 1995;82(2):367–76.PubMedCrossRef
10.
Lascarrou JB, Boisrame-Helms J, Bailly A, Le Thuaut A, Kamel T, Mercier E, et al. Video laryngoscopy vs direct laryngoscopy on successful first-pass orotracheal intubation among icu patients: a randomized clinical trial. JAMA. 2017;317(5):483–93.PubMedCrossRef
11.
Guitton C, Ehrmann S, Volteau C, Colin G, Maamar A, Jean-Michel V, et al. Nasal high-flow preoxygenation for endotracheal intubation in the critically ill patient: a randomized clinical trial. Intensiv Care Med. 2019;45(4):447–58.CrossRef
12.
13.
Martin M, Decamps P, Seguin A, Garret C, Crosby L, Zambon O, et al. Nationwide survey on training and device utilization during tracheal intubation in French intensive care units. Ann Intensive Care. 2020;10(1):2.PubMedPubMedCentralCrossRef
14.
Cook TM, Kelly FE. A national survey of videolaryngoscopy in the United Kingdom. Br J Anaesth. 2017;118(4):593–600.PubMedCrossRef
15.
Driver BE, Prekker ME, Klein LR, Reardon RF, Miner JR, Fagerstrom ET, et al. Effect of use of a bougie vs endotracheal tube and stylet on first-attempt intubation success among patients with difficult airways undergoing emergency intubation: a randomized clinical trial. JAMA. 2018;319(21):2179–89.PubMedPubMedCentralCrossRef
16.
Murakami Y, Ueki R, Niki M, Hirose M, Shimode N. Three-day tracheal intubation manikin training for novice doctors using Macintosh laryngoscope, McGRATH MAC videolaryngoscope and Pentax AirwayScope. Medicine. 2021;100(4):e23886.PubMedPubMedCentralCrossRef
17.
Mosier JM, Whitmore SP, Bloom JW, Snyder LS, Graham LA, Carr GE, et al. Video laryngoscopy improves intubation success and reduces esophageal intubations compared to direct laryngoscopy in the medical intensive care unit. Crit Care. 2013;17(5):R237.PubMedPubMedCentralCrossRef
18.
De Jong A, Clavieras N, Conseil M, Coisel Y, Moury PH, Pouzeratte Y, et al. Implementation of a combo videolaryngoscope for intubation in critically ill patients: a before-after comparative study. Intensiv Care Med. 2013;39(12):2144–52.CrossRef
19.
Noppens RR, Geimer S, Eisel N, David M, Piepho T. Endotracheal intubation using the C-MAC(R) video laryngoscope or the Macintosh laryngoscope: a prospective, comparative study in the ICU. Crit Care. 2012;16(3):R103.PubMedPubMedCentralCrossRef
20.
Arulkumaran N, Lowe J, Ions R, Mendoza M, Bennett V, Dunser MW. Videolaryngoscopy versus direct laryngoscopy for emergency orotracheal intubation outside the operating room: a systematic review and meta-analysis. Br J Anaesth. 2018;120(4):712–24.PubMedCrossRef
21.
Gao YX, Song YB, Gu ZJ, Zhang JS, Chen XF, Sun H, et al. Video versus direct laryngoscopy on successful first-pass endotracheal intubation in ICU patients. World J Emerg Med. 2018;9(2):99–104.PubMedPubMedCentralCrossRef
22.
Huang HB, Peng JM, Xu B, Liu GY, Du B. Video laryngoscopy for endotracheal intubation of critically ill adults: a systemic review and meta-analysis. Chest. 2017;152(3):510–7.PubMedCrossRef
23.
Akihisa Y, Maruyama K, Koyama Y, Yamada R, Ogura A, Andoh T. Comparison of intubation performance between the King Vision and Macintosh laryngoscopes in novice personnel: a randomized, crossover manikin study. J Anesth. 2014;28(1):51–7.PubMedCrossRef
24.
Lee J, Kwak HJ, Lee JY, Chang MY, Lee SY, Kim JY. Comparison of the Pentax AirwayScope and McGrath MAC videolaryngoscope for endotracheal intubation in patients with a normal airway. Medicine. 2017;96(46):e8713.PubMedPubMedCentralCrossRef
25.
Mendonca C, Ungureanu N, Nowicka A, Kumar P. A randomised clinical trial comparing the “sniffing” and neutral position using channelled (KingVision®) and non-channelled (C-MAC®) videolaryngoscopes. Anaesthesia. 2018;73(7):847–55.PubMedCrossRef
26.
Kleine-Brueggeney M, Greif R, Schoettker P, Savoldelli GL, Nabecker S, Theiler LG. Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway: a multicentre randomized controlled trial. Br J Anaesth. 2016;116(5):670–9.PubMedCrossRef
27.
28.
29.
McCrory JW, Matthews JN. Comparison of four methods of preoxygenation. Br J Anaesth. 1990;64(5):571–6.PubMedCrossRef
30.
Higgs A, McGrath BA, Goddard C, Rangasami J, Suntharalingam G, Gale R, et al. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth. 2018;120(2):323–52.PubMedCrossRef
31.
Quintard H, l’Her E, Pottecher J, Adnet F, Constantin JM, De Jong A, et al. Experts’ guidelines of intubation and extubation of the ICU patient of French Society of Anaesthesia and Intensive Care Medicine (SFAR) and French-speaking Intensive Care Society (SRLF) : In collaboration with the pediatric Association of French-speaking Anaesthetists and Intensivists (ADARPEF), French-speaking Group of Intensive Care and Paediatric emergencies (GFRUP) and Intensive Care physiotherapy society (SKR). Ann Intensiv Care. 2019;9(1):13.CrossRef
32.
De Jong A, Rolle A, Pensier J, Capdevila M, Jaber S. First-attempt success is associated with fewer complications related to intubation in the intensive care unit. Intensiv Care Med. 2020;46(6):1278–80.CrossRef
33.
Eismann H, Sieg L, Etti N, Friedrich L, Schröter C, Mommsen P, et al. Improved success rates using videolaryngoscopy in unexperienced users: a randomized crossover study in airway manikins. Eur J Med Res. 2017;22(1):27.PubMedPubMedCentralCrossRef
34.
Pieters BMA, Wilbers NER, Huijzer M, Winkens B, van Zundert AAJ. Comparison of seven videolaryngoscopes with the Macintosh laryngoscope in manikins by experienced and novice personnel. Anaesthesia. 2016;71(5):556–64.PubMedCrossRef
35.
Rendeki S, Keresztes D, Woth G, Mérei Á, Rozanovic M, Rendeki M, et al. Comparison of VividTrac®, Airtraq®, King Vision®, Macintosh laryngoscope and a custom-made videolaryngoscope for difficult and normal airways in mannequins by novices. BMC Anesthesiol. 2017;17(1):68.PubMedPubMedCentralCrossRef
36.
Okada D, Komasawa N, Fujiwara S, Minami T. Comparison of tube-guided and guideless videolaryngoscope for tracheal intubation during chest compression in a manikin: a randomized crossover trial. J Anesth. 2015;29(3):331–7.PubMedCrossRef
37.
Jaber S, Rollé A, Godet T, Terzi N, Riu B, Asfar P, et al. Effect of the use of an endotracheal tube and stylet versus an endotracheal tube alone on first-attempt intubation success: a multicentre, randomised clinical trial in 999 patients. Intensiv Care Med. 2021;47(6):653–64.
38.
Martínez AH, García JMA, Rosete VAM. Intubation time between video-laryngoscopes: King Vision versus Vivid Trac. Comp Study Acta Médica Grupo Ángeles. 2016;14(3):131–5.
39.
Hirsch-Allen AJ, Ayas N, Mountain S, Dodek P, Peets A, Griesdale DE. Influence of residency training on multiple attempts at endotracheal intubation. Can J Anaesth. 2010;57(9):823–9.PubMedCrossRef
40.
Simpson GD, Ross MJ, McKeown DW, Ray DC. Tracheal intubation in the critically ill: a multi-centre national study of practice and complications. Br J Anaesth. 2012;108(5):792–9.PubMedCrossRef
41.
Amalric M, Larcher R, Brunot V, Garnier F, De Jong A, Moulaire Rigollet V, et al. Impact of videolaryngoscopy expertise on first-attempt intubation success in critically ill patients. Crit Care Med. 2020;48(10):e889–96.PubMedCrossRef
42.
Schebesta K, Hüpfl M, Rössler B, Ringl H, Müller MP, Kimberger O. Degrees of reality: airway anatomy of high-fidelity human patient simulators and airway trainers. Anesthesiology. 2012;116(6):1204–9.PubMedCrossRef
43.
Metadata
Title
Comparison of four channelled videolaryngoscopes to Macintosh laryngoscope for simulated intubation of critically ill patients: the randomized MACMAN2 trial
Authors
Paul Decamps
Nicolas Grillot
Aurelie Le Thuaut
Noelle Brule
Corinne Lejus-Bourdeau
Jean Reignier
Jean-Baptiste Lascarrou
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2021
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-021-00916-3

Other articles of this Issue 1/2021

Annals of Intensive Care 1/2021 Go to the issue

Research

The effect of the volemic and cardiac status on brain oxygenation in patients with subarachnoid hemorrhage: a bi-center cohort study

Research

Prevalence and risk factors of hemodynamic instability associated with preload-dependence during continuous renal replacement therapy in a prospective observational cohort of critically ill patients

Research

Oxygen reserve index for non-invasive early hypoxemia detection during endotracheal intubation in intensive care: the prospective observational NESOI study

Research

ABO blood types and sepsis mortality

Letter to the Editor

Triage policy of severe Covid-19 patients: what to do now?

Letter to the Editor

High levels of plasma biomarkers at 24 h were found to be strong predictors of 90-day mortality: beware of some potential confounders!