Randomized controlled trial comparing the McGrath MAC video laryngoscope with the King Vision video laryngoscope in adult patients.

BACKGROUND: This study compares the performance of the McGrath MAC and King Vision laryngoscope systems for endotracheal intubation in adult patients with predicted normal airways when used by experienced laryngoscopists with limited prior video laryngoscopy experience.

METHODS: The study is a randomized controlled trial in a general adult operating suite at an academic medical center in the South Eastern United States. Sixty-six adult surgical patients with predicted easy intubation were enrolled and randomized to undergo endotracheal intubation with either the McGrath MAC video laryngoscope or the King Vision video laryngoscope using the channeled blade attachment. The primary outcomes were success on first attempt and time of intubation. The laryngoscopic view, lowest observed oxygen saturation, number of attempts, assist maneuvers, and documented airway trauma events were also recorded.

RESULTS: The median time for successful intubation was shorter in the McGrath MAC group compared to the King Vision group (17 vs. 38 seconds; P<0.001). There was a higher first attempt success rate in the McGrath MAC group compared to the King Vision group (100% vs. 89%, P<0.01). Also, more patients in the King Vision group had an oxygen desaturation below 90% compared to the McGrath MAC group (3 vs. 0; P<0.034). There were no significant differences between groups in laryngoscopic view, number of attempts, need for assist maneuvers, or airway trauma.

CONCLUSION: The McGrath MAC video laryngoscope allowed for significantly shorter times to endotracheal intubation, higher success rates on first attempt, and fewer desaturations compared to the King Vision video laryngoscope when used by experienced laryngoscopists with limited prior video laryngoscopy experience.