Ease of Intubation with McGrath Videolaryngoscope and Incidence of Adverse Events During Tracheal Intubation in COVID-19 Patients: A Prospective Observational Study.
COVID-19
McGrath
Percentage of Glottic Opening (POGO)
first-pass success
tracheal intubation
videolaryngoscope
Journal
Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)
ISSN: 2393-1809
Titre abrégé: J Crit Care Med (Targu Mures)
Pays: Poland
ID NLM: 101706934
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
15
04
2023
accepted:
19
07
2023
medline:
17
8
2023
pubmed:
17
8
2023
entrez:
17
8
2023
Statut:
epublish
Résumé
Tracheal intubation in critically ill patients remains high-risk despite advances in equipment, technique, and clinical guidelines. Many patients with COVID-19 were in respiratory distress and required intubation that is considered an aerosol-generating procedure (AGP). The transition to videolaryngoscopy as a routine first line option throughout anesthetic and ICU practice has been reported. We evaluated the ease of intubation, success rate, use of accessory maneuvers and adverse outcomes during and 24 hours after intubation with the McGrath videolaryngoscope. This was a prospective, observational single center study conducted at non-operating room locations that included all adults (>18 years old) with suspected or confirmed COVID-19 infection and were intubated by McGrath videolaryngoscope. The anesthesiologist performed tracheal intubation were requested to fill online data collection form. A co-investigator was responsible to coordinate daily with assigned consultants for COVID intubation and follow up of patients at 24 hours after intubation. A total of 105 patients were included in our study. Patients were predominantly male (n=78; 74.3%), their COVID status was either confirmed (n=97, 92.4%) or suspected (n=8, 7.6%). Most were intubated in the COVID ward (n=59, 56.2%) or COVID ICU (n=23, 21.9%). The overall success rate of intubation with McGrath in the first attempt was 82.9%. The glottic view was either full (n=85, 80.95%), partial (n=16, 15.24%) or none (n=4, 3.81%). During intubation, hypoxemia occurred in 18.1% and hypotension in 16.2% patients. Within 24 hours of intubation, pneumothorax occurred in 1.9%, cardiac arrest and return of spontaneous circulation in 6.7% and mortality in 13.3% of patients. These results illustrate the ease and utility of the McGrath videolaryngoscope for tracheal intubation in COVID-19 patients. Its disposable blade is of significant value in protectin during tracheal intubation.
Sections du résumé
Background
UNASSIGNED
Tracheal intubation in critically ill patients remains high-risk despite advances in equipment, technique, and clinical guidelines. Many patients with COVID-19 were in respiratory distress and required intubation that is considered an aerosol-generating procedure (AGP). The transition to videolaryngoscopy as a routine first line option throughout anesthetic and ICU practice has been reported. We evaluated the ease of intubation, success rate, use of accessory maneuvers and adverse outcomes during and 24 hours after intubation with the McGrath videolaryngoscope.
Methods
UNASSIGNED
This was a prospective, observational single center study conducted at non-operating room locations that included all adults (>18 years old) with suspected or confirmed COVID-19 infection and were intubated by McGrath videolaryngoscope. The anesthesiologist performed tracheal intubation were requested to fill online data collection form. A co-investigator was responsible to coordinate daily with assigned consultants for COVID intubation and follow up of patients at 24 hours after intubation.
Results
UNASSIGNED
A total of 105 patients were included in our study. Patients were predominantly male (n=78; 74.3%), their COVID status was either confirmed (n=97, 92.4%) or suspected (n=8, 7.6%). Most were intubated in the COVID ward (n=59, 56.2%) or COVID ICU (n=23, 21.9%). The overall success rate of intubation with McGrath in the first attempt was 82.9%. The glottic view was either full (n=85, 80.95%), partial (n=16, 15.24%) or none (n=4, 3.81%). During intubation, hypoxemia occurred in 18.1% and hypotension in 16.2% patients. Within 24 hours of intubation, pneumothorax occurred in 1.9%, cardiac arrest and return of spontaneous circulation in 6.7% and mortality in 13.3% of patients.
Conclusion
UNASSIGNED
These results illustrate the ease and utility of the McGrath videolaryngoscope for tracheal intubation in COVID-19 patients. Its disposable blade is of significant value in protectin during tracheal intubation.
Identifiants
pubmed: 37588180
doi: 10.2478/jccm-2023-0020
pii: jccm-2023-0020
pmc: PMC10425925
doi:
Types de publication
Journal Article
Langues
eng
Pagination
162-169Informations de copyright
© 2023 Faisal Shamim et al., published by Sciendo.
Déclaration de conflit d'intérêts
Conflict of Interest None to declare.
Références
Br J Anaesth. 2016 May;116(5):670-9
pubmed: 27106971
Crit Care. 2015 Apr 01;19:134
pubmed: 25879683
Anaesthesia. 2020 Jun;75(6):785-799
pubmed: 32221970
Br J Anaesth. 2020 Jul;125(1):16-24
pubmed: 32307115
Int J Crit Illn Inj Sci. 2014 Jan;4(1):35-41
pubmed: 24741496
Br J Anaesth. 2009 Sep;103(3):440-5
pubmed: 19605408
Acad Emerg Med. 1998 Sep;5(9):919-23
pubmed: 9754506
Anaesthesia. 2016 Apr;71(4):466-7
pubmed: 26994533
Anaesthesia. 2015 Nov;70(11):1281-5
pubmed: 26336853
Anaesthesia. 2013 Feb;68(2):142-7
pubmed: 23121470
Resuscitation. 2021 May;162:403-411
pubmed: 33684505
Br J Anaesth. 2015 Dec;115(6):827-48
pubmed: 26556848
Acta Anaesthesiol Scand. 2010 Oct;54(9):1050-61
pubmed: 20887406
Anaesthesia. 2010 Jul;65(7):716-20
pubmed: 20528841
Br J Anaesth. 2020 Jul;125(1):e28-e37
pubmed: 32312571
Anesthesiology. 2022 Jan 1;136(1):31-81
pubmed: 34762729
Anesthesiology. 2020 Jun;132(6):1317-1332
pubmed: 32195705
Medicine (Baltimore). 2016 Jan;95(2):e2514
pubmed: 26765472
PLoS One. 2012;7(4):e35797
pubmed: 22563403
Anesthesiology. 2020 Jun;132(6):1307-1316
pubmed: 32195699
Can J Anaesth. 2020 May;67(5):568-576
pubmed: 32052373