McGRATH MAC video laryngoscope for insertion of a transoesophageal echocardiography probe A randomised controlled trial

被引:17
作者
Ishida, Takashi [1 ]
Kiuchi, Chiaki [1 ]
Sekiguchi, Takemi [1 ]
Tsujimoto, Takatoshi [1 ]
Kawamata, Mikito [1 ]
机构
[1] Shinshu Univ, Sch Med, Dept Anaesthesiol & Resuscitat, 3-1-1 Asahi, Matsumoto, Nagano 3908621, Japan
基金
日本学术振兴会;
关键词
TRACHEAL INTUBATION; ASSISTED INSERTION; CASE SERIES; PERFORATION; DIFFICULT; VIDEOLARYNGOSCOPE; COMPLICATIONS; AIRTRAQ(R); MANAGEMENT; SAFETY;
D O I
10.1097/EJA.0000000000000367
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
BACKGROUND Transoesophageal echocardiography (TOE) probe insertion in anaesthetised patients can cause pharyngeal and oesophageal injuries. Kim et al. have shown that insertion assisted by a Macintosh laryngoscope can reduce such complications but it may sometimes be difficult to observe the passage of a TOE probe. The McGRATH MAC (McGRATH) has been shown to provide a better view of the glottis, piriform fossa and oesophageal inlet during tracheal intubation than the Macintosh. OBJECTIVE We hypothesised that the McGRATH provided better visualisation of the oesophageal inlet and was useful as an aid to TOE probe placement, possibly reducing the incidence of pharyngeal injury related to insertion, compared with the Macintosh. DESIGN A randomised controlled trial. SETTING The study was conducted in a university hospital from February to December 2014. PATIENTS One hundred patients undergoing elective surgery under intraoperative TOE monitoring were randomised to either a Macintosh group or a McGRATH group. INTERVENTIONS Macintosh and McGRATH were used to visualise the passage of the TOE probe and guide its insertion. MAIN OUTCOME MEASURES Visibility of the oesophageal inlet, the number of TOE insertion attempts and incidence of pharyngeal mucosal injury after the TOE probe had been removed were assessed. RESULTS The percentage of patients in whom the oesophageal inlet was visible was higher in the McGRATH group (88%) than in the Macintosh group (41%) (P < 0.01). The number of TOE probe insertion attempts was significantly smaller in the McGRATH group than in the Macintosh group (P = 0.039). The incidence of pharyngeal mucosal injury was significantly smaller in the McGRATH group (4%) than in the Macintosh group (16%; P = 0.042). CONCLUSION The McGRATH provided a better view of the oesophageal inlet and was useful as an aid to TOE probe placement, possibly reducing the incidence of pharyngeal injury related to its insertion. TRIAL REGISTRATION University Hospital Medical Information Network in Japan (UMIN) 000012970.
引用
收藏
页码:263 / 268
页数:6
相关论文
共 19 条
[1]   Hypopharyngeal perforation near-miss during transesophageal echocardiography [J].
Aviv, JE ;
Di Tullio, MR ;
Homma, S ;
Storper, IS ;
Zschommler, A ;
Ma, GG ;
Petkova, E ;
Murphy, M ;
Desloge, R ;
Shaw, G ;
Benjamin, S ;
Corwin, S .
LARYNGOSCOPE, 2004, 114 (05) :821-826
[2]  
Bakhos David, 2011, Ear Nose Throat J, V90, pE1
[3]   Esophageal Perforation, the Most Feared Complication of TEE: Early Recognition by Multimodality Imaging [J].
Bavalia, Nisha ;
Anis, Ather ;
Benz, Michael ;
Maldjian, Pierre ;
Bolanowski, Paul J. ;
Saric, Muhamed .
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2011, 28 (03) :E56-E59
[4]   Safety of Transesophageal Echocardiography [J].
Hilberath, Jan N. ;
Oakes, Daryl A. ;
Shernan, Stanton K. ;
Bulwer, Bernard E. ;
D'Ambra, Michael N. ;
Eltzschig, Holger K. .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2010, 23 (11) :1115-1127
[5]   Airtraq laryngoscope for the insertion of a transesophageal echocardiography probe [J].
Hirabayashi, Yoshihiro ;
Okada, Osamu ;
Seo, Norimasa .
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2008, 22 (02) :331-332
[6]   GlideScope-assisted insertion of a transesophageal echocardiography probe [J].
Hirabayashi, Yoshihiro .
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2007, 21 (04) :628-628
[7]   Successful tracheal intubation with the McGrath® MAC video laryngoscope after failure with the Pentax-AWS™ in a patient with cervical spine immobilization [J].
Hyuga, Shunsuke ;
Sekiguchi, Takemi ;
Ishida, Takashi ;
Yamamoto, Katsumi ;
Sugiyama, Yuki ;
Kawamata, Mikito .
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 2012, 59 (12) :1154-1155
[8]   Expected difficult tracheal intubation: a prospective comparison of direct laryngoscopy and video laryngoscopy in 200 patients [J].
Jungbauer, A. ;
Schumann, M. ;
Brunkhorst, V. ;
Boergers, A. ;
Groeben, H. .
BRITISH JOURNAL OF ANAESTHESIA, 2009, 102 (04) :546-550
[9]  
Kallmeyer IJ, 2001, ANESTH ANALG, V92, P1126
[10]   Gastroesophageal perforation after intraoperative transesophageal echocardiography [J].
Kharasch, ED ;
Sivarajan, M .
ANESTHESIOLOGY, 1996, 85 (02) :426-428