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In the presented study, our aim was to compare intubation conditions regarding the modified Cormack & Lehane score (CL) between the D-Blade® in indirect laryngoscopy or Macintosh blade in direct and indirect laryngoscopy with C-MAC PM® in a simulated setting of a difficult airway in human subjects.
Patients with unexpected difficult airway requiring endotracheal intubation (ETI) remain extremely challenging for emergency physicians and intubation failure with subsequent hypoxic complications still represents the majority of cases in a recent closed claims analysis.
An incidence of major complications in airway management of 1 in 5,500 was estimated in the Fourth National Audit Project in the UK.
Therefore, our aim was to compare intubation conditions regarding the modified Cormack & Lehane score (CL) between the D-Blade® in indirect laryngoscopy or Macintosh blade in direct and indirect laryngoscopy with C-MAC PM® in a simulated setting of a difficult airway in human subjects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | All patients received the same treatment.
|
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Macintosh blade | Device | Laryngoscopy with C-MAC PM in combination with Macintosh blade |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Best view of the glottic structures | Best view of the glottic structures according to the modified Cormack and Lehane (CL) scoring system | 120 seconds after induction of narcosis |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate the process of Intubation using a questionnaire | As a secondary endpoint, all investigators were asked to evaluate the process of ETI with the D-Blade® from grade 1 to grade 4. Grade 1: Uncomplicated ETI with guide rod Grade 2: Challenging ETI, readjustment or usage of BURP necessary Grade 3: ETI using a stylet Grade 4: ETI failed | Directly after successful tracheal intubation |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Haitham Mutlak, Dr. med. | Department of Anesthesia, Intensive Care Medicine and Pain Therapy | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Frankfurt | Frankfurt am Main | Hesse | 60590 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31065384 | Derived | Raimann FJ, Dietze PE, Cuca CE, Meininger D, Kessler P, Byhahn C, Gill-Schuster D, Zacharowski K, Mutlak H. Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM(R) with Macintosh Blade and D-Blade(R) in a Simulated Difficult Airway. Emerg Med Int. 2019 Apr 1;2019:1067473. doi: 10.1155/2019/1067473. eCollection 2019. |
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| ID | Term |
|---|---|
| D007440 | Intubation |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D008919 | Investigative Techniques |
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| D-Blade |
| Device |
Laryngoscopy with C-MAC PM in combination with D-Blade |
|
| Intubation | Device | Intubation with C-MAC PM in combination with D-Blade |
|
| Subjective assessment of satisfaction using numeric rating scale | Finally, all investigators were asked for their subjective assessment from 0 = dissatisfied to 100 = fully satisfied when using the D-Blade®. | Directly after successful tracheal intubation |