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Published on: January 17, 2011
A Comparison of McGrath Mac and HugeMed Video Laryngoscopes in Pediatric Patients Under 3 Years Old-A Prospective
Gamze Tanirgan Cabakli1, Kemal Tolga Saracoglu2, Ruslan Abdullayev1
1Department of Anesthesiology and Reanimation, Marmara University Medical School, 34899 Istanbul, Turkey.
Insights
The McGrath Mac videolaryngoscope offers superior laryngeal visualization in children under three compared to the HugeMed device. While it improves Cormack-Lehane and Percentage of Glottic Opening scores, overall intubation success rates remain similar.
Area of Science:
- Pediatric Anesthesiology
- Airway Management
- Medical Device Technology
Background:
- Pediatric patients face higher risks of airway management complications and intubation difficulties.
- Videolaryngoscopes are established tools for pediatric airway management, but device superiority is unclear.
- This study addresses the need for comparative data on videolaryngoscope effectiveness in young children.
Purpose of the Study:
- To compare the first pass success rate and glottic visualization using Cormack-Lehane (CML) and Percentage of Glottic Opening (POGO) scores.
- To evaluate the performance of HugeMed and McGrath Mac videolaryngoscopes in pediatric patients with unanticipated difficult airways.
- To assess intubation time, attempts, and hemodynamic parameters between the two videolaryngoscope groups.
Main Methods:
- A randomized study of 40 pediatric surgical patients (age ≤3 years, ASA 1-3) undergoing general anesthesia.
- Patients were intubated using either the McGrath Mac (n=20) or HugeMed (n=20) videolaryngoscope.
- CML and POGO scores were recorded via direct and indirect laryngoscopy; intubation success, time, and complications were monitored.
Main Results:
- No significant demographic or hemodynamic differences were observed between the McGrath Mac and HugeMed groups.
- Indirect laryngoscopy significantly improved CML and POGO scores in both groups (p < 0.001).
- The McGrath Mac group demonstrated significantly lower CML scores (p = 0.0034) and higher mean POGO scores (92.63 ± 6.09) compared to the HugeMed group (88.75 ± 4.44).
Conclusions:
- Videolaryngoscopes enhance laryngeal visualization in children under three years old.
- The McGrath Mac videolaryngoscope showed superiority over HugeMed in achieving better CML and POGO scores via indirect laryngoscopy.
- Despite improved visualization, no significant differences were found in intubation attempts, success rates, or complications between the devices.
Background:
Children generally face a higher incidence of airway management complications, intubation difficulties, and the risk of failed intubation. Currently, there is sufficient evidence in clinical practice for the use of videolaryngoscopes in pediatric airway management. However, there are a number of standard-blade videolaryngoscopes available for children. In addition, there is no clear recommendation on which videolaryngoscope is superior. The primary objective of this study is to compare the first pass success rate and the Percentage of Glottic Opening (POGO) scores with Cormack-Lehane (CML) scores obtained through direct and indirect laryngoscopy with HugeMed and McGrath Mac videolaryngoscopes in pediatric patients with an unanticipated, difficult airway.
Materials And Methods:
Following the Ethics Committee approval and written parental consents, a total of 40 elective surgical patients, aged 3 and under, with ASA 1-3 risk classification, and undergoing general anesthesia, were included in the study. After induction of general anesthesia, the first group of patients (Group McGrath, n = 20) was intubated with the McGrath Mac videolaryngoscope, and the second group (Group HugeMed, n = 20) with the HugeMed videolaryngoscope. Before intubation, CML and POGO scores were recorded for both groups using direct and indirect laryngoscopy with videolaryngoscopes. Intubation time, number of attempts, need for cricoid pressure, optimization maneuver requirement, and hemodynamic parameters were recorded for both groups.
Results:
There was no significant difference between groups in demographic data including age, gender, body mass index, ASA, and hemodynamic parameters. A significant improvement was observed in CML and POGO scores using indirect laryngoscopy (p < 0.001). CML scores obtained with the McGrath Mac were significantly lower than the HugeMed Group (p = 0.0034). The mean POGO value calculated with indirect laryngoscopy was significantly higher in the McGrath Group compared to the HugeMed Group (92.63 ± 6.09 vs. 88.75 ± 4.44, respectively).
Conclusions:
Videolaryngoscopes improved laryngeal visualization in children under 3 years old. Compared to HugeMed, in indirect laryngoscopy, the McGrath Mac videolaryngoscope was found to be superior, with better CML and POGO scores. However, number of tracheal intubation attempts, success rate, complication risk, and hemodynamic parameters did not show any significant difference between the groups. Clinical trial registration number was NCT06484517.
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