McGRATH™ MAC

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McGRATH™ MAC video laryngoscope

The McGRATH™ MAC video laryngoscope is proven to improve first time success rate,1,2 and potentially lessen hemodynamic response to intubation3,4 when compared to the traditional direct visualization technique.

In this MedEd Bytes series, we learn about the application of the McGRATH™ MAC video laryngoscope to improve intubation success.

Byte 1: Consequences of difficult intubations

Approximately 6% of intubations are difficult intubations. These difficult intubations are associated with adverse events such as oxygen desaturation, increased risk of hypertension, unexpected ICU admission, and death.5,6

Byte 2: Predicting difficult intubation

With existing methods, the majority of difficult intubations, as many as 93% of them, are unanticipated.7

Byte 3: The EMMA trial

In the EMMA trial, the McGRATH™ MAC video laryngoscope (VL) was compared to the Macintosh direct laryngoscope (DL) for routine intubation in the operating room.2

Byte 4: De Jong et al. 2022

In this study, the percent of intubations classified as easy, defined as intubations with a Cormack and Lehane grades of I or II as well as absence of mask ventilation or rescue technique, increased from about 94.3% to 98.7% concomitant with the increased use of video laryngoscopy.8

1

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. May 2016;116(5):670–9. doi:10.1111/anae.15985.

2

Kriege M, Noppens RR, Turkstra T, et al. A multicentre randomised controlled trial of the McGrath™ Mac video laryngoscope versus conventional laryngoscopy. Anaesthesia. 2023;78(6):722–729. doi:10.1111/anae.15985.

3

Altun D, Ali A, Çamcı E, Özonur A, Seyhan T. Haemodynamic response to four different laryngoscopes. Turk J Anaesthesiol Reanim. 2018;46(6):434–440. doi:10.5152/tjar.2018.59265.

4

Yokose M, Mihara T, Kuwahara S, Goto T. Effect of the McGRATH MAC® video laryngoscope on hemodynamic response during tracheal intubation: a retrospective study. PLoS One. 2016;11(5):e0155566. doi:10.1371/journal.pone.0155566.

5

Cook TM, MacDougall-Davis SR. Complications and failure of airway management. Br J Anaesth. 2012;109 Suppl 1:i68–i85. doi:10.1093/bja/aes393.

6

Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology. 2005;103(2):429–37. doi:10.1097/00000542-200508000-00027.

7

Nørskov AK, Rosenstock CV, Wetterslev J, Astrup G, Afshari A, Lundstrøm LH. Diagnostic accuracy of anaesthesiologists' prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database. Anaesthesia. 2015;70(3):272–81. doi:10.1111/anae.12955.

8

De Jong A, Sfara T, Pouzeratte Y, et al. Videolaryngoscopy as a first-intention technique for tracheal intubation in unselected surgical patients: a before and after observational study. Br J Anaesth. 2022;129(4):624–634. doi:10.1016/j.bja.2022.05.030.