The online version of this article (doi:10.1186/1471-2253-14-101) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
JWI has seen the original study data, reviewed the analysis of the data, and approved the final manuscript. CSE has seen the original study data, approved the final manuscript, and is the author responsible for archiving the study files. DSC has seen the original study data, reviewed the analysis of the data, and approved the final manuscript. MPM reviewed the analysis of the data and approved the final manuscript.
Rigid video laryngoscopes are popular alternatives to direct laryngoscopy for intubation, but further large scale prospective studies comparing these devices to direct laryngoscopy in routine anesthesiology practice are needed. We hypothesized that the first pass success rate with one particular video laryngoscope, the GlideScope, would be higher than the success rate with direct laryngoscopy.
3831 total intubation attempts were tracked in an observational study comparing first-pass success rate using a Macintosh or Miller-style laryngoscope with the GlideScope. Propensity scoring was then used to select 626 subjects matched between the two groups based on their morphologic traits.
Comparing the GlideScope and direct laryngoscopy groups suggested that intubation would be more difficult in the GlideScope group based on the Mallampati class, cervical range of motion, mouth opening, dentition, weight, and past intubation history. Thus, a propensity score based on these factors was used to balance the groups into two 313 patient cohorts. Direct laryngoscopy was successful in 80.8% on the first-pass intubation attempt, while the GlideScope was successful in 93.6% (p <0.001; risk difference of 0.128 with a 95% CI of 0.0771 – 0.181).
A greater first-attempt success rate was found when using the GlideScope versus direct laryngoscopy. In addition, the GlideScope was found to be 99% successful for intubation after initial failure of direct laryngoscopy, helping to reduce the incidence of failed intubation.
Practice guidelines for management of the difficult airway: An updated report by the American Society of Anesthesiologists Task Force for Management of the Difficult Airway. Anesthesiology. 2013, 118: 251-270. 10.1097/ALN.0b013e31827773b2. CrossRef
Aziz MF, Healy D, Kheterpal S, Fu RF, Dillman D, Brambrink AM: Routine clinical practice effectiveness of the glidescope in difficult airway management: An analysis of 2004 glidescope intubations, complications, and failures from two institutions. Anesthesiology. 2011, 114 (1): 34-41. 10.1097/ALN.0b013e3182023eb7. CrossRefPubMed
Maassen R, Lee R, Hermans B, Marcus M, van Zundert A: A comparison of three videolaryngoscopes: the Macintosh laryngoscope blade reduces, but does not replace, routine stylet use for intubation in morbidly obese patients. Anesth Analg. 2009, 109 (5): 1560-1565. 10.1213/ANE.0b013e3181b7303a. CrossRefPubMed
Thoemmes F, Kim ES: A Systematic Review of Propensity Score Methods in the Social Sciences. Multivar Behav Res. 2011, 46: 90-118. 10.1080/00273171.2011.540475. CrossRef
Peterson GN, Domino KB, Caplan RA, Posner KL, Lee LA, Cheney FW: Management of the difficult airway: a closed claims analysis. Anesthesiology. 2005, 101 (1): 33-39. CrossRef
Cross P, Cytryn J, Cheng KK: Perforation of the soft palate using the GlideScope videolaryngoscope. Can J Anaesthesiol. 2007, 54: 588-589. 10.1007/BF03022329. CrossRef
el-Ganzouri AR, McCarthy RJ, Tuman KJ, Tanck EN, Ivankovich AD: Preoperative airway assessment: Predictive value of a multivariate risk index. Anesth Analg. 1996, 82: 1197-1204. PubMed
- GlideScope Use improves intubation success rates: an observational study using propensity score matching
James W Ibinson
Catalin S Ezaru
Daniel S Cormican
Michael P Mangione
- BioMed Central
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