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Master Thesis

Comparaison du vidéo-laryngoscope McGrath® MAC pédiatrique et du laryngoscope direct pour l’intubation par des novices chez des enfants sans critères d’intubation difficile : une étude randomisée contrôlée

Abstract : Background: Airway management and tracheal intubation are routinely performed in pediatric anesthesia and yet are associated with preventable adverse events. Video laryngoscopes have been developed to facilitate and shorten tracheal intubation. McGrath® MAC is a video laryngoscope with a curved blade similar to the Macintosh blade, which has not been previously described in first intention pediatric tracheal intubation. Aim: To compare direct laryngoscopy to the McGrath® MAC video laryngoscope among novice laryngoscopists. Method: Six pediatric anesthesia residents with novice skills in pediatric laryngoscopy were randomly assigned to perform tracheal intubation using either direct Macintosh laryngoscopy (DL) or the McGrath® MAC video laryngoscope (MM) as the first attempted device in children weighing between 10 and 20 kg without difficult intubation. Results: One Hundred thirty two children were enrolled in our study between August 2013 and April 2015. Time To Intubation (TTI) was shorter in the DL group (n = 67) compared to the MM group (n = 65) with 42 s (35-50) vs. 48 s (43-58) P = 0.002. Time To Best View (TTBV) was similar between the two groups (10 s (7-16) vs. 10 s (8-15) P = 0.50), Tube Passage Time (TPT) was shorter with DL (29 s (25-35) vs. 35 s (30-45) P = 0.0002) and either Cormack & Lehane grade or POGO score were similar between groups. Minor reversible respiratory adverse events were similar between groups: 12 in DL group (17.9 %) vs. 12 in MM group (18.5 %). Conclusion: McGrath® MAC video laryngoscopy, when performed by a novice laryngoscopist, leads to a longer intubation times in easy-to-intubate children, mostly due to a longer time to pass the tracheal tube after obtaining an optimal glottis exposition.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01417681
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Thursday, December 15, 2016 - 6:19:12 PM
Last modification on : Wednesday, August 23, 2017 - 4:33:28 PM
Long-term archiving on: : Tuesday, March 21, 2017 - 7:42:19 AM

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Antoine Giraudon. Comparaison du vidéo-laryngoscope McGrath® MAC pédiatrique et du laryngoscope direct pour l’intubation par des novices chez des enfants sans critères d’intubation difficile : une étude randomisée contrôlée. Médecine humaine et pathologie. 2016. ⟨dumas-01417681⟩

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