Use of the McGRATH™ MAC: To view or not to view?

• Published in: Trends in anaesthesia & critical care 2018-04, Vol.19, p.25-33
• Main Authors: Normand, Katherine C., Vargas, Leslie A., Burnett, Tyrone, Sridhar, Srikanth, Cai, Chunyan, Zhang, Xu, Markham, Travis H., Guzman-Reyes, Sara, Hagberg, Carin A.
• Format: Article
• Language: English
• Subjects: Airway management; Difficult airway; Difficult tracheal intubation; Direct laryngoscopy; Indirect laryngoscopy; Video-assisted laryngoscopy (VAL)
• ISSN: 2210-8440
• DOI: 10.1016/j.tacc.2018.02.003

Due to the life-threatening consequences that a failed tracheal intubation entails, many efforts have been made to identify specific patient features, which may predict difficulty during tracheal intubation. In addition, debate exists as to whether or not video-assisted laryngoscopy (VAL) should replace direct laryngoscopy and if airway practitioners will lose their skills associated with direct laryngoscopy, now that VAL use has increased in clinical practice. This study was designed to determine the first attempt success rate of tracheal intubation with the McGRATH™ MAC laryngoscope using direct visualization in patients with known difficult airways, as well as exploring the possibility of identifying a particular direct Cormack-Lehane (C-L) grade view where indirect (video) visualization can be most beneficial during laryngoscopy and intubation. Following IRB/ethical board approval and written informed consent, 100 adult patients (age > 18 years) with an ASA status I-III and a BMI  43 cm for males), thyromental distance