Optimizing GlideScope~R Laryngoscopy: An In Vitro Study on an Airway Model

摘要

To the Editor:-The GlideScope~R Videolaryngoscope (GVL; Diagnostic Ultrasound Corporation, Bothell, WA, and Saturn Biomedical Systems Inc., Burnaby, British Columbia, Canada) has a video camera incorporated in the undersurface of its curved plastic blade, providing a detailed airway image on an integrated monitor. The shape of the GVL partially resembles the shape of the standard Macintosh laryngoscope (fig. 1A). However, a 60?upward angulation of the distal half of the blade allows for an easy visualization of the larynx, which is often better than that of a rigid laryngoscopy. Despite better laryngoscopic view with the GVL, intubation using a Macintosh laryngoscope was significantly faster. In addition, in one series of 728 patients, the intubation failure rate of the GVL was 3.7% despite the ability to obtain grade 1 or 2 views most of the time.3'' The paradox that the GVL provided better glottic visualization but not easy intubation may have been caused by patient-related factors, insufficient skills of intubators, and/or limitations of the device, intubation with the GVL is limited by a sole reliance on the video image, because a line-of-sight view is nonexistent. We wondered whether this special design of the GVL might actually hinder accomplishment of intubation as a central purpose of the device.