Expert review of medical devices · 2025
Comparison of laryngeal exposure in bed-up-head-elevated Macintosh laryngoscopy vs. supine C-MAC video laryngoscopy: a randomized non-inferiority trial.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sirohiya Prashant, Sagiraju Hari Krishna Raju, Ahuja Vasudha, Gupta Nishkarsh, Kumar Vinod, Ratre Brajesh Kumar, Kumar Balbir, Vig Saurabh, Gupta Raghav, Bhopale Shweta, Pandit Anuja, Bhatnagar Sushma
Аннотация
BACKGROUND: Tracheal intubation can be challenging, especially in unanticipated cases, where patient positioning plays a critical role. The bed-up-head-elevated (BUHE) position may improve intubation outcomes.
RESEARCH DESIGN AND METHODS: This randomized non-inferiority trial included 90 ASA I-II patients undergoing elective surgery. Patients were randomly allocated into two groups. Group 1 underwent Macintosh laryngoscopy in the BUHE position followed by C-MAC laryngoscopy in the supine position, while Group 2 followed the reverse order. Endotracheal intubation was attempted with the second blade used for laryngoscopy. Laryngeal exposure was evaluated using Percentage of Glottic Opening (POGO) scores and Cormack - Lehane (CL) grading with a non-inferiority margin of -15% for POGO scores. Secondary outcomes included time required for intubation, attempts, adjuncts, effort, and complications.
RESULTS: BUHE Macintosh laryngoscopy yielded a mean POGO score of 50.5% compared to 63.4% with supine C-MAC laryngoscopy, with a mean difference of -12.9% (95% CI: -16.6% to -9.3%). CL grading favored C-MAC, while secondary outcomes showed no significant differences.
CONCLUSION: BUHE Macintosh laryngoscopy resulted in lower laryngeal exposure, as the confidence interval crossed the non-inferiority margin. However, secondary outcomes remained comparable. Further studies are required to validate these findings and refine non-inferiority margins.
TRIAL REGISTRATION-: CTRI/2023/02/050036.
RESEARCH DESIGN AND METHODS: This randomized non-inferiority trial included 90 ASA I-II patients undergoing elective surgery. Patients were randomly allocated into two groups. Group 1 underwent Macintosh laryngoscopy in the BUHE position followed by C-MAC laryngoscopy in the supine position, while Group 2 followed the reverse order. Endotracheal intubation was attempted with the second blade used for laryngoscopy. Laryngeal exposure was evaluated using Percentage of Glottic Opening (POGO) scores and Cormack - Lehane (CL) grading with a non-inferiority margin of -15% for POGO scores. Secondary outcomes included time required for intubation, attempts, adjuncts, effort, and complications.
RESULTS: BUHE Macintosh laryngoscopy yielded a mean POGO score of 50.5% compared to 63.4% with supine C-MAC laryngoscopy, with a mean difference of -12.9% (95% CI: -16.6% to -9.3%). CL grading favored C-MAC, while secondary outcomes showed no significant differences.
CONCLUSION: BUHE Macintosh laryngoscopy resulted in lower laryngeal exposure, as the confidence interval crossed the non-inferiority margin. However, secondary outcomes remained comparable. Further studies are required to validate these findings and refine non-inferiority margins.
TRIAL REGISTRATION-: CTRI/2023/02/050036.