A randomized controlled study on the visual grading of the glottis and the hemodynamics response to laryngoscopy when using I-View and MacGrath Mac videolaryngoscopes in super obese patients.

Abstract

Videolaryngoscopes improve visualization of glottic in morbidly obese patients. Super-obesity is one of the risk factors influencing probability of difficult mask ventilation and difficult intubation. Super-obese (BMI > 50kg/m2) patients should be intubated either with fiberscope awake intubation or with video laryngoscopes. In prospective observational study we decided to compare glottis view during intubation using I-view and McGrath Mac videolaryngoscopes in super obese patients. Patients were randomly allocated into group M (McGrath Mac) or group I (I-View). Obtained view was analyzed regarding POGO (Percentage Of Glottis Opening) scale and the necessity to use of additional aid like intubation stylet was recorded. Hemodynamic response to videolaryngoscopy was assessed. As results POGO score was better in group M when compared to group I: 81.66 ± 22.8% vs 96.66 ± 7.24% (p = 0.0132) in I and V groups respectively. The use of intubation stylet was similar in both groups. The hemodynamic response to videolaryngoscopy was similar between groups. The POGO score was better for McGrath Mac than for I-view videolaryngoscope, however, both devices allowed for safe and effective intubation in super-obese patients. The hemodynamic response to videolaryngoscopy was similar between devices.