Airway Management Study to Evaluate the C-MAC Video Laryngoscope as an Alternative to the Direct Laryngoscopy

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the C-MAC video laryngoscope in difficult airway situations.

Detailed Description
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Unanticipated difficulties during tracheal intubation and failure to intubate are among the leading causes of anaesthesia related morbidity and mortality. Using the technique of video laryngoscopy, the alignment of the oral and pharyngeal axis to facilitate endotracheal intubation is obsolete. In this study we evaluate the C-MAC video laryngoscope (STORZ, Tuttlingen, Germany) for endotracheal intubation in difficult intubation situations (Cormack & Lehane (CL) grade 3 and 4) validated by Macintosh laryngoscope. We hypothesize that endotracheal intubation is possible using the C-MAC in patients after failed direct laryngoscopy. We also examine whether visualisation of the glottis is improved with this device compared to direct laryngoscopy and possible complications such as soft tissue injury.

Official Title
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Evaluation of the C-MAC Video Laryngoscope After Failed Direct Laryngoscopy

Conditions
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Unexpected Difficult Airway

Intervention / Treatment
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* Device: Endotracheal intubation using the C-MAC video laryngoscope


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Unexpected difficult airway Exclusion Criteria: History of difficult or impossible mask ventilation Age < 18 years ASA grade > 3 Emergency surgery

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: C-MAC<br>After a maximum of three failed intubation attempts using direct laryngoscope the C-MAC video laryngoscope is used as an emergency airway device. | Device: Endotracheal intubation using the C-MAC video laryngoscope<br>* Using the C-MAC video laryngoscope for endotracheal intubation after failed direct laryngoscopy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success rate of endotracheal intubation using the C-MAC video laryngoscope | The investigators evaluate the C-MAC as an alternative after failed direct laryngoscopy. Primary outcome measure is the success rate using the C-MAC video laryngoscope in unexpected difficult airways. |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| - improved glottic view | According to the Cormacl-Lehane classification the improved glottis view using the C-MAC is documented. |  | 
| - complications | Possible complications are supra glottic trauma, tooth damage, soft tissure bleeding,... |  | 
| - numbers of intubation attempts | Necessary intubation attempts using the C-MAC video laryngoscope to secutre the airway. |  | 
| - size of blade (C-MAC) | Different blades are available for the C-MAC. We evaluate with which blade securing the airway was possible. |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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difficult airway, indirect laryngoscopy, C-MAC video laryngoscope