C-MAC Video Laryngoscope versus Conventional Direct Laryngoscopy for Endotracheal Intubation During Cardiopulmonary Resuscitation.

Byeong Chul Min,Minsu Park,Jong Eun Park,Tae Gun Shin,Heewon Han,Keun Jeong Song,Tae Rim Kim,Hee Yoon,Won Chul Cha,Gun Tak Lee,Sung Yeon Hwang

doi:10.3390/medicina55060225

Byeong Chul Min, Minsu Park + Show 9 more

Open Access

https://doi.org/10.3390/medicina55060225

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Abstract

Background and objectives: To compare the first pass success (FPS) rate of the C-MAC video laryngoscope (C-MAC) and conventional Macintosh-type direct laryngoscopy (DL) during cardiopulmonary resuscitation (CPR) in the emergency department (ED). Materials and Methods: This study was a single-center, retrospective study conducted from April 2014 to July 2018. Patients were categorized into either the C-MAC or DL group, according to the device used on the first endotracheal intubation (ETI) attempt. The primary outcome was the FPS rate. A multiple logistic regression model was developed to identify factors related to the FPS. Results: A total of 573 ETIs were performed. Of the eligible cases, 263 and 310 patients were assigned to the C-MAC and DL group, respectively. The overall FPS rate was 75% (n = 431/573). The FPS rate was higher in the C-MAC group than in the DL group, but there was no statistically significant difference (total n = 431, 79% compared to 72%, p = 0.075). In the multiple logistic regression analysis, the C-MAC use had higher FPS rate (adjusted odds ratio: 1.80; 95% CI, 1.17–2.77; p = 0.007) than that of the DL use. Conclusions: The C-MAC use on the first ETI attempt during cardiopulmonary resuscitation in the emergency department had a higher FPS rate than that of the DL use.

Highlights

Airway management is a key component of cardiopulmonary resuscitation (CPR), the optimal strategy for airway management during CPR remains unknown [1,2]
263 and 310 patients were assigned to the C-MAC and direct laryngoscopy (DL) group, respectively
The first pass success (FPS) rate was higher in the C-MAC group than in the DL group, but there was no statistically significant difference

Summary

Introduction

Airway management is a key component of cardiopulmonary resuscitation (CPR), the optimal strategy for airway management during CPR remains unknown [1,2]. Endotracheal intubation (ETI) is frequently performed during CPR in the emergency department (ED). Studies comparing the usefulness of VL with direct laryngoscopy (DL) in various situations in the ED have been published. It has produced conflicting results, existing literature supports VL use in the ED [5,6,7]. To compare the first pass success (FPS) rate of the C-MAC video laryngoscope (C-MAC) and conventional Macintosh-type direct laryngoscopy (DL) during cardiopulmonary resuscitation (CPR) in the emergency department (ED). The FPS rate was higher in the C-MAC group than in the DL group, but there was no statistically significant difference

Methods

Results

Conclusion