title: First clinical evaluation of the C-MAC D-Blade videolaryngoscope during routine and difficult intubation.
abstract: In the present preliminary study we evaluated the C-MAC® D-Blade (Karl Storz, Tuttlingen, Germany), a new videolaryngoscopic C-MAC blade for difficult intubation, during both routine and difficult intubations. First, both the conventional direct laryngoscopy and the D-Blade were used in 15 consecutive patients with normal airways during routine induction of anesthesia. Second, the D-Blade was used as a rescue device in 20 of 300 (6.7%) consecutive patients, when conventional direct laryngoscopy failed. In the 15 patients during routine induction of anesthesia, with direct laryngoscopy, a Cormack-Lehane (C/L) grade 1 and grade 2a view was seen in 7 and 8 patients, respectively. It was possible to insert the D-Blade and to get a video view of the glottis on the first attempt in all patients; with the D-Blade, all 15 patients had a C/L 1 view. The time to successful intubation with the D-Blade was 15 (8-26) seconds (median (range)). In the 20 patients, in whom unexpected difficulty with direct laryngoscopy was observed, C/L grades 3 and 4 were present in 15 and 5 patients, respectively. With the use of the D-Blade, indirect C/L video view improved to C/L class 1 in 15 patients, and to 2a in 5 patients, respectively. The time from touching the laryngoscope to optimal laryngoscopic view was 11 (5-45) seconds and for successful intubation 17 (3-80) seconds. In all 35 patients, with the D-Blade no direct view of the glottis was possible and subsequently a semiflexible tube guide was required.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, D-24105 Kiel, Germany. cavus@anaesthesie.uni-kiel.de
authors.forename: Erol
authors.initials: E
authors.lastname: Cavus
authors.forename: Tobias
authors.initials: T
authors.lastname: Neumann
authors.forename: Volker
authors.initials: V
authors.lastname: Doerges
authors.forename: Thora
authors.initials: T
authors.lastname: Moeller
authors.forename: Edwin
authors.initials: E
authors.lastname: Scharf
authors.forename: Klaus
authors.initials: K
authors.lastname: Wagner
authors.forename: Berthold
authors.initials: B
authors.lastname: Bein
authors.forename: Goetz
authors.initials: G
authors.lastname: Serocki
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D005858:Germany; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013514:Surgical Procedures, Operative; D013997:Time Factors; D014741:Video Recording; D055815:Young Adult