title: An evaluation of McCoy balloon laryngoscopy in patients with moderate-to-major endotracheal intubation difficulty.
abstract: We hypothesized that combined McCoy-balloon laryngoscopy may facilitate airway management relative to McCoy or balloon laryngoscopy. In 10 anesthetized/paralyzed patients with prior intubation difficulty scale scores of >5, McCoy-balloon laryngoscopy versus conventional/balloon/McCoy laryngoscopies resulted in greater laryngeal aperture exposure (2.3 +/- 0.6 versus 0.6 +/- 0.2/1.4 +/- 0.4/1.5 +/- 0.6 cm2, respectively), lower intubation difficulty scale score (0.00 (0.00-0.00) versus 6.00 (6.00-8.25)/1.50(0.00-4.00)/2.00(0.75-5.00), respectively, median [interquartile range]), and 9%-74% shorter time to intubation confirmation (P < 0.05-0.001 for all). Balloon and McCoy laryngoscopies improved laryngoscopic/intubating conditions relative to conventional laryngoscopy. In patients with moderate-to-major conventional airway management difficulty, McCoy-balloon laryngoscopy further improves laryngoscopic/intubating conditions.
  
  
  CONCLUSIONS
  This study shows that, in patients with moderate-to-major conventional airway management difficulty, combined McCoy-balloon laryngoscopy results in improved laryngoscopic/intubating conditions when compared with the conventional, McCoy, and balloon laryngoscopic techniques. McCoy-balloon laryngoscopy combines the merits of McCoy and balloon laryngoscopy and can be recommended for patients with moderate-to-major intubation difficulty.
authors.affiliation: Departments of Intensive Care Medicine Henry Dunant General Hospital and Evaggelismos General Hospital, Athens, Greece.
authors.forename: Spyros D
authors.initials: SD
authors.lastname: Mentzelopoulos
authors.forename: Maria
authors.initials: M
authors.lastname: Tzoufi
authors.forename: Kostas
authors.initials: K
authors.lastname: Rellos
authors.forename: Argyris S
authors.initials: AS
authors.lastname: Michalopoulos
authors.forename: Elissavet
authors.initials: E
authors.lastname: Stamataki
authors.forename: Charris
authors.initials: C
authors.lastname: Roussos
authors.forename: Spyros G
authors.initials: SG
authors.lastname: Zakynthinos
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged