Medtronic Announces New Developments in Anesthesia Safety

Events at the World Airway Management Meeting (WAMM) 2019 revealed an evolution in laryngoscopy

During difficult intubations, video laryngoscopy is the most frequently selected and successful rescue technique after failed direct laryngoscopy.  Large studies show the rate of aspiration and cardiac arrest increase by 13% and 11%, respectively, after more than two laryngoscopy attempts.¹ 

And although approximately 80% of airway-related incidents reported in these studies resulted in a full recovery, 2% resulted in brain damage and 12% ultimately resulted in patient death.^1,2 Difficult intubations have also been shown to contribute approximately $2 billion in increased annual costs in the United States.³

Broad, global adoption of video laryngoscopy for routine use is showing positive impact on patient and economic outcomes.

Supporting this evolution, data presented at WAMM from the randomized, controlled Evaluation of the McGRATH MAC and Macintosh laryngoscope for tracheal intubation in 2000 patients undergoing general anesthesia: the randomized multicenter EMMA trial study, showed higher first-attempt success during intubation when using a video laryngoscope device compared to a direct laryngoscope even in routine airways.⁴

Rudy Noppens, MD, PHD, FRCPC, Associate Professor, Department of Neuroanesthesia, Department of Physiology and Pharmacology, Western University, Canada, and study author, examined 2,171 patients and found first-pass intubation success rate was higher with the McGRATH MAC™ VL 1019/1084 (94%), compared with DL 896/1087 (82%; p<0.0001). Time for intubation was shorter with DL 34 s (IQR [26-45]), compared to McGRATH MAC™ VL 36 s [26-47]; p=0.0005.⁴

The next generation McGRATH™ MAC video laryngoscope,^† which is designed for routine use, has improved optics^5,6,7,8,9 compared to the previous version and an intelligent auto-off feature to decrease battery drainage during idle time.¹⁰ The McGRATH™ MAC video laryngoscope enables multiple disposable, sterile blade options for pediatric and adult patients as well as those with extreme airways.^6,7,8 It is portable, durable,¹⁴ and cost-effective¹⁵– so it’s in reach for every intubation. And it provides better visualization than traditional Macintosh laryngoscopy,^13,16,17 has achieved higher intubation success rates compared to other video laryngoscopes,^18,19 and is associated with a shorter time to intubation and higher first-attempt success rates.¹⁹

Also presented at WAMM, a Medtronic-conducted study examined the cost burden associated with difficult intubations in the United States.²⁰ Data showed the median cost difference between inpatient surgical admissions between 10/1/2015 and 3/31/2018 with a diagnosis code indicating difficult intubation and similar admissions without a difficult intubation code is $20,231.²⁰ The findings support the hypothesis that the median reported cost for cases with difficult intubation is higher than median cost for cases matched for procedure and severity of illness but without difficult intubation.

†May not be available for sale in all markets

 

1. NAP4.  DAS, 2011 Mjr Complications of Airway Mgmt UK
2. Cook™, MacDougall-Davis SR. Complications and failure of airway management. Br J Anaesth. 2012;1099(suppl 1):i68-i85.
3. Premier Healthcare Database White Paper: Data that informs and performs, July 29,
4. Kriege M, Alflen C, Tzanova I, Schmidtmann I, Piepho T, Noppens RR. Evaluation of the McGrath MAC and Macintosh laryngoscope for tracheal intubation in 2000 patients undergoing general anaesthesia: the randomised multicentre EMMA trial study protocol. BMJ Open. 2017;7(8). doi:10.1136/bmjopen-2017-016907.
5. RE00120930
6. 310-033-000 Lens Assembly A02 Rev 1
7. OVM7690-R20A
8. Omnivision_OV6922
9. 2019-09-27 Test Report A02 versus A03_rev X01
10. RE00216471 PRD 7
11. Gaszyński T. Comparison of the glottic view during video-intubation in super obese patients: a series of cases. Ther Clin Risk Manag. 2016;12:1677–1682.
12. Szarpak L, Truszewski Z, Czyzewski L, Gaszynski T, Rodríguez-Núñez A. A comparison of the McGRATH™-MAC and Macintosh laryngoscopes for child tracheal intubation during resuscitation by paramedics. A randomized, crossover, manikin study. Am J Emerg Med. 2016;34(8):1338–1341.
13. Ross M, Baxter A. Use of the new McGRATH™® MAC size-1 paediatric videolaryngoscope. Anaesthesia. 2015;70(10):1217–1218.
14. Based on REP352 Drop Test (Hand Held) of McGRATH MAC Video Laryngoscope (001-015-000 revision)
15. Noppens R, Alsumali A. cost effectiveness of video laryngoscopy for routine use in the operating room. 2018;23:10. doi: 10.1016/j.tacc.2018.09.008.
16. Kim JE1, Kwak HJ2, Jung WS2, Chang MY1, Lee SY1, Kim JY1. A comparison between McGrath MAC videolaryngoscopy and Macintosh laryngoscopy in children. Acta Anaesthesiol Scand. 2018 Mar;62(3):312-318.
17. Yoo JY1, Park SY1, Kim JY1, Kim M1, Haam SJ2, Kim DH1. Comparison of the McGrath videolaryngoscope and the Macintosh laryngoscope for double lumen endobronchial tube intubation in patients with manual in-line stabilization: A randomized controlled trial. Medicine (Baltimore). 2018 Mar;97(10):e0081.
18. Kleine-Brueggeney M, Greif R, Schoettker P, Savoldelli GL, Nabecker S, Theiler LG. Evaluation of six video laryngoscopes in 720 patients with a simulated difficult airway: a multicentre randomized controlled trial. Br J Anaesth. 2016;116(5):670-9.
19. Alvis BD, et al. Randomized controlled trial comparing the McGRATH™ MAC video laryngoscope with the King Vision™* video laryngoscope in adult patients. Minerva Anestesiol. 2016;82(1):30-35.
20. Phillips K†, Moucharite M†, Wong T†, May R††. Cost burden associated with difficult intubation in the United States. †Medtronic, Mansfield, MA, US, †† Medtronic, Boulder, CO, US.

Source: Medtronic