Comparison of endotracheal intubation using direct and video laryngoscopes in the ICU

Excerpt

In a prospective, comparative study, Noppens and colleagues [1] demonstrated that, compared with the Macintosh direct laryngoscope (MDL), the C-MAC videolaryngoscope (C-MAC) improved laryngeal view and achieved a higher intubation success rate on first attempt in patients with predictors of difficult intubation in the ICU. In the Materials and methods, however, the authors did not mention what position the patient's head was placed during laryngoscopy. This may be unimportant for the C-MAC, which does not require the alignment of the oral, pharyngeal, and tracheal axes to visualize the glottis [2]. When using the MDL, however, the patient's head should always be in a sniffing position, which aligns the oral, pharyngeal, and laryngeal axis into more of a straight line [3]. We believe that when the laryngoscopic views with direct and video laryngoscopes are used as endpoints, negligence of this factor would have significantly underestimated the performance of the MDL, particularly in patients with predictors of difficult intubation. …