Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjan.2013.03.001
Brazilian Journal of Anesthesiology
Scientific Article

Eficácia do videolaringoscópio C-MAC no manejo de intubações malsucedidas inesperadas

Effectiveness of the C-MAC video laryngoscope in the management of unexpected failed intubations

Alper Kilicaslan; Ahmet Topal; Aybars Tavlan; Atilla Erol; Seref Otelcioglu

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Resumo

Justificativa e objetivos: O objetivo deste estudo foi fazer uma revisão das experiências de um departamento de anestesiologia em relação ao uso do videolaringoscópio C-MAC em tentativas malsucedidas de intubação. Métodos: Analisamos os dados de 42 pacientes, cujas tentativas de intubação com o uso delaringoscopia direta (Macintosh) tinham falhado e nos quais o videolaringoscópio C-MAC foi usado como o dispositivo de resgate primário. A taxa de sucesso do C-MAC em intubação foi avaliada e a visão da laringe em ambos os dispositivos foi comparada. Resultados: Com o laringoscópio Macintosh, o escore de Cormack e Lehane foi 3 em 41 pacientes e 4 em um paciente e com o CMAC, foi 1 em 27 pacientes, 2 em 14 pacientes e 3 em um paciente. Intubação traqueal com CMAC foi bem-sucedida em 36 pacientes (86%) na primeira tentativa e em seis pacientes (14%) na segunda tentativa. Nenhuma complicação foi observada, além de pequena lesão (sangue na lâmina) em oito pacientes (19%). Conclusão: Esses dados fornecem evidência para a eficácia clínica do videolaringoscópio C-MAC no manejo de intubações malsucedidas inesperadas em assistência rotineira de anestesia. O videolaringoscópio C-MAC é eficiente e seguro como dispositivo de resgate primário em intubações malsucedidas inesperadas.

Palavras-chave

Manejo das vias aéreas, Laringoscopia, Intubação difícil

Abstract

Background and objectives: The purpose of this study was to review the experiences of an anesthesiology department regarding the use of a C-MAC videolaryngoscope in unexpected failed intubation attempts. Methods: Data were analyzed from 42 patients whose intubation attempts using Macintosh direct laryngoscopes had failed, and on whom a C-MAC videolaryngoscope was utilized as the primary rescue device. The success rate of C-MAC in intubation was assessed, and laryngeal views from both devices were compared. Results: The Cormack and Lehane score was III in 41 patients, and IV in one patient, with the Macintosh laryngoscope, while Cormack and Lehane score was I in 27 patients, II in 14 and III in one with CMAC. Tracheal intubation with CMAC was successful on the first attempt in 36 patients (86%), and on the second attempt in 6 patients (14%). No complications were observed other than minor damage (blood on blade) in 8 patients (19%). Conclusion: These data provide evidence for the clinical effectiveness of C-MAC videolaryngoscope in managing the unexpected failed intubations in routine anesthesia care. The C-MAC videolaryngoscope is efficient and safe as a primary rescue device in unexpected failed intubations.

Keywords

Airway management, Laryngoscopy, Difficult intubation

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