• Manuel Taboada, Ana Estany-Gestal, María Rial, Agustín Cariñena, Adrián Martínez, Salomé Selas, María Eiras, Sonia Veiras, Esteban Ferreiroa, Borja Cardalda, Carmen López, Andrea Calvo, Jorge Fernández, Julián Álvarez, Jorge Miguel Alcántara, and Teresa Seoane-Pillado.
• Department of Anaesthesiology, University Clinical Hospital of Santiago, Santiago de Compostela, Spain. Electronic address: manutabo@yahoo.es.
• J. Cardiothorac. Vasc. Anesth. 2024 Jul 1; 38 (7): 149915051499-1505.

ObjectiveTracheal intubation in cardiac surgery patients has a higher incidence of difficult laryngoscopic views compared with patients undergoing other types of surgery. The authors hypothesized that using the McGrath Mac videolaryngoscope as the first intubation option for cardiac surgery patients improves the percentage of patients with "easy intubation" compared with using a direct Macintosh laryngoscope.DesignA prospective, observational, before-after study.SettingAt a tertiary-care hospital.ParticipantsOne thousand one hundred nine patients undergoing cardiac surgery.InterventionConsecutive patients undergoing cardiac surgery were intubated using, as the first option, a Macintosh laryngoscope (preinterventional phase) or a McGrath Mac videolaryngoscope (interventional phase).Measurements And Main ResultsThe main objective was to assess whether the use of the McGrath videolaryngoscope, as the first intubation option, improves the percentage of patients with "easy intubation," defined as successful intubation on the first attempt, modified Cormack-Lehane grades of I or IIa, and the absence of the need for adjuvant airway devices. A total of 1,109 patients were included, 801 in the noninterventional phase and 308 in the interventional phase. The incidence of "easy intubation" was 93% in the interventional phase versus 78% in the noninterventional phase (p < 0.001). First-success-rate intubation was higher in the interventional phase (304/308; 98.7%) compared with the noninterventional phase (754/801, 94.1%; p = 0.005). Intubation in the interventional phase showed decreases in the incidence of difficult laryngoscopy (12/308 [3.9%] v 157/801 [19.6%]; p < 0.001), as well as moderate or difficult intubation (5/308 [1.6%] v 57/801 [7.1%]; p < 0.001).ConclusionsThe use of the McGrath videolaryngoscope as the first intubation option for tracheal intubation in cardiac surgery improves the percentage of patients with "easy" intubation," increasing glottic view and first-success-rate intubation and decreasing the incidence of moderate or difficult intubation.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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