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To investigate the impact of Macintosh blade size used during direct laryngoscopy DL on first-attempt intubation success of orotracheal intubation in French intensive care units ICUs.
We hypothesized that success rate would be higher with Macintosh blade size No3 than with No4. Multicenter retrospective observational study based on data from prospective trials conducted in 48 French ICUs of university, and general and private hospitals. Complications rates associated with intubation were investigated. Primary outcome was success rate of first DL using Macintosh blade.
A total of intubations were collected, with a Macintosh blade No3 and with a No4. Incidence of first-pass intubation after first DL was significantly higher with Macintosh blade No3 Complications rates were equivalent between groups. Multivariate analysis concluded to a significant impact of Macintosh blade size on first DL success in favor of blade No3 OR 1. Propensity scores and adjustment analyses concluded to equivalent results.
However, study design requires the conduct of a nationwide prospective multicenter randomized trial in different settings to confirm these results. Control of upper airways and ventilation of intensive care unit ICU patients is a daily issue worldwide.
