Use of McGrath MAC Videolaryngoscope to Assist Transesophageal Echocardiography Probe Insertion in Intubated Patients

• Published in: Journal of cardiothoracic and vascular anesthesia 2017-02, Vol.31 (1), p.191-196
• Main Authors: Kavrut Ozturk, Nilgun, MD, Kavakli, Ali Sait, MD
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia & Perioperative Care; Anesthesia, General - methods; Cardiac Surgical Procedures - methods; Critical Care; Echocardiography, Transesophageal - adverse effects; Echocardiography, Transesophageal - methods; Female; Hemodynamics - physiology; Humans; Intubation, Intratracheal - methods; Laryngoscopes - adverse effects; Laryngoscopy - adverse effects; Laryngoscopy - instrumentation; Laryngoscopy - methods; Male; Middle Aged; pharyngeal injury; Pharynx - injuries; Prospective Studies; success rate; Time Factors; transesophageal echocardiography; Video Recording - instrumentation; videolaryngoscope
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2016.03.150

Objectives Transesophageal echocardiography (TEE) probe insertion with the conventional blind insertion technique may be difficult in anesthetized and intubated patients. The use of a videolaryngoscope may facilitate the insertion of the TEE probe. The aim of this study was to compare the conventional technique with the use of the McGrath MAC videolaryngoscope for TEE probe insertion in terms of success rate, duration of insertion, and complications in patients undergoing cardiovascular surgery. Design A prospective, randomized study. Setting Training and research hospital. Participants Eighty-six adult patients undergoing cardiovascular surgery were included. Interventions Eighty-six adult patients were randomized into 2 groups: conventional group (n = 43) and McGrath videolaryngoscope group (n = 43). Success rates, duration of insertion, complications, and hemodynamic changes during insertion were recorded. Measurements and Main Results The success rate of TEE probe insertion at the first attempt was higher in the McGrath videolaryngoscope group (90.5%) than in the conventional group (43.9%) (p = 0.012). The mean duration for successful insertion of the TEE probe at the first attempt was longer in the McGrath videolaryngoscope group (24 s v 11 s) (p = 0.016). The total time for successful insertion of the TEE probe was similar in both groups. Pharyngeal injuries were observed more frequently in the conventional group (17.1% v 2.4%) (p = 0.037). The rate of blood presence on the probe tip in the conventional group was higher than in the McGrath group (21.9% v 4.8%). There were no statistical differences between the 2 groups in systolic blood pressure, mean arterial pressure, diastolic blood pressure, and heart rate before and after TEE insertion. Conclusions The use of the McGrath MAC videolaryngoscope for TEE insertion in cardiovascular surgery patients increases the success rate and reduces pharyngeal injuries compared to the conventional technique. The use of the McGrath MAC videolaryngoscope for TEE insertion causes similar hemodynamic changes as in the conventional blind insertion technique.