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KMID : 1140520180220030035
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Korean Journal of Emergency Medical Services
2018 Volume.22 No. 3 p.35 ~ p.45
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Comparison of tracheal intubation using the Miller blade versus Macintosh blade in difficult airway: A manikin study among novice intern doctors
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Lee Mi-Lim
Kim Chul-Tae
Lee Hyo-Cheol
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Abstract
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Purpose: The purpose of this study was to compare laryngoscopic views and ease of use and success of intubation, via the percentage of glottic opening (POGO) scale when using the Miller blade and Macintosh blade in paraglossal approach.
Methods: Forty intern doctors were randomized for laryngoscopy to be performed in a crossover manner. They performed endotracheal intubation with Miller blade and Macintosh blade in two airway scenarios: normal airway and difficult airway with edema. We observed the rate of successful intubation, time required for visualizing the glottis, time to complete endotracheal intubation, ease of intubation, and the POGO scale.
Results: In the normal airway, there was no difference in intubation between the two endoscopes. In the difficult airway, the time for visualizing the glottis (7.80 versus 10.24 sec; p=.006), the time to tube passage (19.38 versus 23.03 sec; p=.038) and the time to complete endotracheal intubation (21.84 versus 28.54 sec; p=.022) with Miller blade was shorter than with Macintosh blade. The POGO scale(%) of the Miller blade was higher than that of the Macintosh blade’s (62.25 versus 56.32; p=.030).
Conclusion: Compared to the Macintosh blade, Miller blade provided better visualization of the glottis and POGO scale, and faster time to completion of endotracheal intubation.
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KEYWORD
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Paraglossal approach, Miller blade, Macintosh blade, Difficult airway, Intubation, POGO
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