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* From the Department of Anesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario;
Saturn Biomedical Systems,
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; and
the Departments of Anesthesiology and Medicine, University of Washington and Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
Address correspondence to: Dr. Richard M. Cooper, Department of Anesthesia and Pain Management, Toronto General Hospital, 200 Elizabeth Street, 3 EN-421, Toronto, Ontario M5G 2C4, Canada. Phone: 416-340-3242; Fax: 416-340-3698; E-mail: richard.cooper{at}uhn.on.ca
Purpose: To evaluate a new videolaryngoscope and assess its ability to provide laryngeal exposure and facilitate intubation.
Methods: Five centres, involving 133 operators and a total of 728 consecutive patients, participated in the evaluation of a new video-laryngoscope [GlideScope® (GS)]. Many operators had limited or no previous GS experience. We collected information about patient demographics and airway characteristics, Cormack-Lehane (C/L) views and the ease of intubation using the GS. Failure was defined as abandonment of the technique.
Results: Data from six patients were incomplete and were excluded. Excellent (C/L 1) or good (C/L 2) laryngeal exposure was obtained in 92% and 7% of patients respectively. In all 133 patients in whom both GS and direct laryngoscopy (DL) were performed, GS resulted in a comparable or superior view. Among the 35 patients with C/L grade 3 or 4 views by DL, the view improved to a C/L 1 view in 24 and a C/L 2 view in three patients. Intubation with the GS was successful in 96.3% of patients. The majority of the failures occurred despite a good or excellent glottic view.
Conclusions: GS laryngoscopy consistently yielded a comparable or superior glottic view compared with DL despite the limited or lack of prior experience with the device. Successful intubation was generally achieved even when DL was predicted to be moderately or considerably difficult. GS was abandoned in 3.7% of patients. This may reflect the lack of a formal protocol defining failure, limited prior experience or difficulty manipulating the endotracheal tube while viewing a monitor.
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