Successful airway management with combined use of McGrath® MAC video laryngoscope and fiberoptic bronchoscope in a severe obese patient with huge goiter: a case report / 대한마취과학회지

Huge goitor can lead to tracheal compression and hence difficulty in intubation. This is compounded by severe obesity. Failed tracheal intubation in difficult intubation is a serious event that may lead to increased patient morbidity and mortality. Current intubation rescue techniques and combination of different rescue techniques may increase the success rate of difficult intubation. In a 47-year-old female patient, with severe obesity and a huge goiter, our attempts at intubation using direct laryngoscope, video laryngoscope, and awake fiberoptic bronchoscope had failed. We succeeded by applying video laryngoscope to improve visualization of the airway and fiberoptic bronchoscope as a stylet for endotracheal tube.

Ease of Intubation with the McGRATH® MAC, C-MAC® or Macintosh Laryngoscopes by Novice Operators in Simulated Difficult Airways – A Manikin Study.

A variety of video laryngoscopes have been introduced to facilitate endotracheal intubations as failed intubations can result in morbidity and mortality. We aimed to compare the use of the conventional Macintosh laryngoscope, McGRATH® MAC and C- MAC® video laryngoscopes among novice operators. 37 medical students were recruited to perform oro-tracheal intubations in a human patient stimulator with simulated ‘difficult airway’ scenario using 3 devices: The Macintosh laryngoscope, McGRATH® MAC and C- MAC® video laryngoscopes. The success rate of tracheal intubation using the C-MAC® video laryngoscope (84%) was higher than both the McGRATH® MAC (59%) and the Macintosh laryngoscope (57%) (p=0.005). The use of video laryngoscopes were associated with lower incidence of oesophageal intubation (p<0.001) and deemed easier to use (p<0.001). Overall, the C-MAC® yielded a higher rate of successful tracheal intubation, a shorter time to glottic visualisation and was deemed to provide the greatest ease of intubation with novice practitioners.

The Use of McGrath® MAC Video Laryngoscope in Difficult Airway.

Rigid indirect video laryngoscopes were designed to aid glottis visualisation in difficult airway. The McGrath® MAC video laryngoscope was designed similarly for routine use. The unique design of the blade makes it easy to use in patients with limited mouth opening and facilitates tracheal intubation without use of stylet. It is compact and easy to assemble with preparation time less than one minute making it a reasonable choice in cases of unanticipated difficult intubations. This case series demonstrates its successful use as a rescue device in patients with difficult intubation. One of the patient was intubated awake with the help of McGrath® MAC video laryngoscope thus making it an attractive alternate for fibre optic bronchoscopy assisted tracheal intubation.