Academic literature on the topic 'Cormack - Lehane grade'

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Journal articles on the topic "Cormack - Lehane grade"

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Qamar, Kiran, Sheikh Ziarat Ali, Saba Naveed, Mehtab Tipu Chaudary, Fariha Aslam, and Nazia Rubab Maqbool. "Positive Predictive Value of Upper Lip Bite Test in Predicting Difficult Intubation." Pakistan Journal of Medical and Health Sciences 16, no. 4 (2022): 326–29. http://dx.doi.org/10.53350/pjmhs22164326.

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Objective: To determine the positive predictive value of upper lip bite test in predicting difficult intubation by taking Cormack and Lehane classification as gold standard. Design of the Study: Cross sectional study. Study Settings: This cross-sectional study was conducted at Department of Anesthesiology, Sir Ganga Ram Hospital, Lahore from 04/06/2021 to 03/12/2021. Materials and Methods: This study involved 313 patients of both genders, aged between 18-70 years undergoing general anesthesia on elective lists having positive upper lip bite test (Grade-III). On the basis of Cormack and Lehane Classification, the diagnosis was verified. Results of the ULBT were compared to the Cormack and Lehane grade-III and grade-IV diagnoses. Every patient's written informed permission was obtained. Results: In The mean age of the patients was 43.78±12.32 years. Majority (n=150, 47.9%) of the patients were aged between 36-52 years. There were 198 (63.3%) male and 115 (36.7%) female patients in the study group. Among the procedures, herniorrhaphy (32.9%) and cholecystectomy (26.8%) were the more frequent procedures followed by thyroidectomy (17.6%), tonsillectomy (13.1%) and mastectomy (9.6%). Majority (42.8%) of the patients belonged to ASA Class-I followed by ASA Class-II (29.7%) and ASA Class-III (27.5%). Difficult intubation was confirmed in 232 (74.1%) patients on Cormack and Lehane Classification (as per operational definition). Thus there were 232 true positive patients with 81 false positive patients. With the gold standard Cormack and Lehane Classification, the upper lip bite test yielded a positive predictive value of 74.1 percent in the prediction of difficult intubation. Conclusion: According to the gold standard of Cormack and Lehane Classification, an upper lip bite test (Grade-III) has a 74.1 percent positive predictive value for difficult intubation in patients undergoing general anaesthesia with endotracheal intubation on the elective list. Keywords: Difficult Intubation, Cormack and Lehane Classification, Upper Lip Bite Test
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Zulfiqar, Hassam, Hashaam Ghafoor, Muhammad Haroon Anwar, Jawad Zahir, Farzana Mazhar Bokhari, and Inam Ul Haq. "Comparison of Laryngoscopic Glottic Views Obtained via Macintosh vs Miller Blade in Adults Undergoing General Anesthesia with Endotracheal Intubation." Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University 19, no. 3 (2023): 266–71. http://dx.doi.org/10.48036/apims.v19i3.830.

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Objective: To compare the glottic views obtained through Miller and Macintosh blade laryngoscopy in adults undergoing general anesthesia with endotracheal intubation. Methodology: This quasi-experimental study was conducted at Holy Family Hospital, Rawalpindi, from June 2022 to September 2022. Sixty patients scheduled for elective surgery under general anesthesia with endotracheal intubation were enrolled. Patients were randomly assigned to two groups: Miller blade group (n=30) and Macintosh blade group (n=30). The anesthesiologist conducting the intubation recorded the Cormack Lehane grade obtained. Data analysis utilized SPSS version 27.0, employing independent-sample t-tests, Mann-Whitney U tests, chi-square, or Fisher's exact tests as appropriate. A p-value <0.05 was considered statistically significant. Results: In the Miller blade group, comprising 30 patients, the mean age was 44.60+13.310 years, and 53.3% were male. Cormack-Lehane grades were distributed as follows: 76.7% grade I, 20.0% grade II, and 3.3% grade III. In the Macintosh blade group, with 30 patients, the mean age was 40.93+12.798 years, and 46.7% were male. Cormack-Lehane grades were distributed as follows: 30.0% grade I, 50.0% grade II, 13.3% grade III, and 6.7% grade IV. Conclusion: The study concluded that Miller blade laryngoscopy provides superior glottic views compared to Macintosh blade laryngoscopy. However, the ease of intubation and the time taken for intubation were not investigated, suggesting areas for exploration in future studies.
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Yin, Ning, Lei Fang, Li Zhang, et al. "Predictor of postoperative dyspnea for Pierre Robin Sequence infants." Open Medicine 15, no. 1 (2020): 915–20. http://dx.doi.org/10.1515/med-2020-0231.

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AbstractThe aim of this retrospective study is to determine the predictive factors of postoperative dyspnea in infants with Pierre Robin sequence (PRS). Forty children with PRS, who underwent general anesthesia, were retrospectively analyzed. The patient’s physiological status and anesthesiology data were collected accordingly, demographic characteristics including age, gender, height and weight at surgery, weight gain, preoperative airway status, tracheal intubation route, American Society of Anesthesiologists grading and airway Cormack–Lehane classification. Weight gain, dyspnea before the operation, Cormack–Lehane grade distribution showed a significant difference between patients with and without postoperative dyspnea (p = 0.0175, p = 0.0026, and p = 0.0038, respectively). Incompetent weight gain was identified as a predictor (p = 0.0371) of PRS postoperative dyspnea through the binary logistic regression model. In conclusion, this study established an early alerting model by monitoring the weight gain, dyspnea before the operation, Cormack–Lehane grade as potential combinations to predict the risk of postoperative dyspnea for PRS.
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Dhaka, Satyapal, Sunita Meena, Gopal Bansal, Bheru Dan Charan, Meenu Bagarhatta, and Vandana Mangal. "USE OF ULTRASOUND PARAMETERS FOR PREDICTION OF DIFFICULT INTUBATION AND ITS RELATION WITH THE CORMACK AND LEHANE GRADE OF LARYNGOSCOPY." International Journal of Advanced Research 9, no. 01 (2021): 606–11. http://dx.doi.org/10.21474/ijar01/12334.

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Background and AIMS: Airway ultrasound is novel,safe and noninvasive modality that help in predicting difficult airway.This study aimed todetermine the usefulness of airway ultrasound in order to predict difficult intubation. Method:- This was a hospital based prospective observational study on 100 patients aged 18-60 years of either sex undergoing elective surgery under general anaesthesia with endotracheal intubation.Preoperatively physical airway evaluation was performed byusing six parameters including Modified Mallampati class(MMC), thyromental distance(TMD), sternomental distance(SMD) , inter-incisor (IID)distance , hyomental distance(HMD)and neck circumference(NC). In preoperatively, Airway Ultrasoundwas performed andnoted the ratio of the depth of the pre‑epiglottic space (PES) to the distance from the epiglottis to the mid‑point of the distance between the vocal cords (E‑VC). CL grade was also noted during laryngoscopy. Compared ultrasound parameters with Cormack–Lehane grade. Specificity,Sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracywere calculated.Airway ultrasound measurements were compared with physical parametersin predicting Cormack –Lehane grade. Results: The incidence of difficult intubation was 7%. Sensitivity of PES/E-VC ratio was higher than NC, TMD, HMD, IID and SMD but less than Mallampati class. Specificity, PPV was lower than physical parameters.NPV was comparable. Conclusion: Percutaneous airway ultrasound is useful and promising technique for predicting Cormack and Lehane grading but a combination of all these is definitely helpful for better prediction.
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Thayyil, Baseema, Neetha Thattaparambil Chandran, Asish Karthik, and Maya Gomathy Amma. "Comparison of Upper Lip Bite Test and Ratio of Height to Thyromental Distance in Predicting Difficult Tracheal Intubation in South Indian Population – A Descriptive Study." Journal of Evidence Based Medicine and Healthcare 8, no. 27 (2021): 2412–16. http://dx.doi.org/10.18410/jebmh/2021/447.

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BACKGROUND Failure in managing the airway is the most important cause of death in patients undergoing general anaesthesia (GA). For effectively preventing airway catastrophe it is essential to have a meticulous airway assessment pre-operatively. Many methods are in use to predict difficult airway like Mallampati, Wilson’s scoring, percentage of glottic opening (POGO) scoring, Cormack - Lehane classification, thyromental distance, mandibular hyoid distance, atlantooccipital joint extension etc. In this study, we compared between two popular methods of airway assessment, upper lip bite test (ULBT) and height to thyromental distance ratio (RHTMD) to predict the difficulty in tracheal intubation. METHODS This descriptive study was conducted at Government Medical college, Thrissur, over a period of one year , on 76 patients of American society of Anaesthesiologist (ASA) - PS l - lll, requiring general anaesthesia. ULBT and RHTMD were used to assess the patient’s airway. It was correlated with Cormack - Lehane classification during direct laryngoscopy. The data was analysed using Fisher exact test (P < 0.05) and Kappa statistics. RESULTS Out of the 76 patients, 41 (53.9%) were women 35 were men (46.1 %). ULBT predicted 89.6 % [25 + 43] belonging to class 1 and 2 as easy, while 10.5 % [8] of class 3 as difficult. RHTMD predicted 35 patients (46 %) as easy (grade 1) and 41 patients (54 %) as grade 2. Using ULBT, of the 8 patients predicted to have difficult intubation (Class 3), 2 were found practically difficult and 6 were easy. In remaining 68 patients, 23 patients had difficult view and 45 had easy view. According to Cormac and Lehane, among 41 patients who predicted difficult by RHTMD, 19 patients were practically difficult and 22 were easy. Of 35 patients, 6 patients were difficult and 29 were easy. CONCLUSIONS The RHTMD is more sensitive compared to ULBT in predicting difficult intubation. As assessed by Cormack - Lehane classification. KEYWORDS Difficult Intubation, Ratio of Height to Thyromental Distance, Upper Lip Bite Test
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Arulkumaran, Nishkantha, Charles S. McLaren, Kailash Arulkumaran, Barbara J. Philips, and Maurizio Cecconi. "An analysis of emergency tracheal intubations in critically ill patients by critical care trainees." Journal of the Intensive Care Society 19, no. 3 (2018): 180–87. http://dx.doi.org/10.1177/1751143717749686.

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Introduction We evaluated intensive care medicine trainees’ practice of emergency intubations in the United Kingdom. Methods Retrospective analysis of 881 in-hospital emergency intubations over a three-year period using an online trainee logbook. Results Emergency intubations out-of-hours were less frequent than in-hours, both on weekdays and weekends. Complications occurred in 9% of cases, with no association with time of day/day of week (p = 0.860). Complications were associated with higher Cormack and Lehane grades (p=0.004) and number of intubation attempts (p < 0.001), but not American Society of Anesthesiologist grade. Capnography usage was ≥99% in all locations except in wards (85%; p = 0.001). Ward patients were the oldest (p < 0.001), had higher American Society of Anesthesiologist grades (p < 0.001) and lowest Glasgow Coma Scale (p < 0.001). Conclusions Complications of intubations are associated with higher Cormack and Lehane grades and number of attempts, but not time of day/day of week. The uptake of capnography is reassuring, although there is scope for improvement on the ward.
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Acharya, Pragya, Anil Shrestha, Arjun Gurung, Megha Koirala, Gentle Sundar Shrestha, and Moda Nath Marhatta. "Effect of Head Elevation to Different Heights in Laryngeal Exposure with Direct Laryngoscopy." Journal of Nepal Health Research Council 17, no. 2 (2019): 168–72. http://dx.doi.org/10.33314/jnhrc.v0i0.1721.

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Background: The purpose of this study was to determine the optimal pillow height for the best laryngoscopic view in adult patients scheduled for elective surgery under general anaesthesia.Methods: 150 adult patients undergoing surgery under general anaesthesia with endotracheal intubation with no features suggestive of difficult airway were enrolled for the study. After induction of anaesthesia the assessment of direct laryngoscopic views was done at head positions without a pillow and with non-compressible pillows of heights 5cm and 10cm.Results: The laryngoscopic view with the 5cm pillow was significantly superior to other head position (p<0.01). The incidence of difficult laryngoscopy (Cormack and Lehane grade III) was 32.7% without a pillow which improved to (Cormack and Lehane grade III) 4% with 10cm pillow and there were no cases of difficult laryngoscopy with 5cm pillow.Conclusions: The use of 5cm pillow in the ‘sniffing’ position obtains the best laryngoscopic view during direct laryngoscopy.Keywords: Direct laryngoscopy; head elevation; laryngoscopicview; pillow height.
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Graham, Colin A., Angela J. Oglesby, Diana Beard, and Dermot W. McKeown. "Laryngoscopic views during rapid sequence intubation in the emergency department." CJEM 6, no. 06 (2004): 416–20. http://dx.doi.org/10.1017/s1481803500009416.

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ABSTRACT:Objectives:Our objective was to document and compare the views obtained at laryngoscopy during emergency department (ED) rapid sequence intubation (RSI) by anesthetists and emergency physicians of varying seniority and experience.Methods:Data were prospectively collected on every intubation attempt in 7 urban Scottish EDs for 2 calendar years, commencing Jan. 11, 1999. Data included patient’s age, gender, grade and specialty of intubator, laryngoscopic grade, and number of intubation attempts. Quality of laryngoscopic visualization was graded using the Cormack–Lehane scale, with grades I and II considered good visualization. A descriptive analysis was performed, and key statistical comparisons made.Results:During the study period, 735 patients underwent RSI, and grade of intubation was documented in 672 cases (91%). In total, 68.2%, 23.4%, 6.1% and 2.4% of the intubations were classified as Cormack–Lehane grade I, II, III and IV respectively. Overall, anesthetists and anesthesia trainees achieved good laryngoscopic visualization in 94.0% of cases (95% confidence interval [CI], 90.8%–96.4%) and emergency physicians and emergency medicine trainees did so in 89.2% of cases (95% CI, 85.5%–92.3%;p= 0.027). Specialist registrars and senior house officers in anesthesia were more likely to obtain good visualization than their emergency medicine counterparts (p= 0.034 and 0.035 respectively). Consultants in emergency medicine were more likely to obtain good views than their anesthesia counterparts, but this difference was not statistically significant.Conclusions:Anesthetic trainees obtain better laryngoscopic views than emergency medicine trainees, but these differences disappear with increasing emergency physician seniority, suggesting a training and experience effect. Emergency medicine trainees may benefit from additional focus on laryngoscopic visualization techniques early in their training period.
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Shah, Prerana N., and Kaveri Das. "McGrath Video Laryngoscope May Take a Longer Intubation Time Than Macintosh Laryngoscope." Journal of Anesthesiology 2015 (November 26, 2015): 1–4. http://dx.doi.org/10.1155/2015/901903.

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Background. Video laryngoscopes provide better view and can improve ease of intubation compared with standard laryngoscopes. Methods. A prospective randomized study was done on 60 patients, 18 to 65 years old, comparing McGrath video laryngoscope and Macintosh laryngoscope. The aim was to compare the ease, efficacy, and usability of them during routine airway management. The primary endpoint was duration of intubation and the secondary endpoints were Cormack and Lehane grade of laryngoscopic view, number of intubation attempts, and incidence of complications. Results. There was an increase in total duration of intubation with McGrath video laryngoscope with 42.9 ± 19.5 seconds compared to Macintosh laryngoscope with 17.9 ± 4.6 seconds. In Macintosh group, 73.3% had grade I, 20% had grade II, and 6.7% had grade III Cormack Lehane view, while in McGrath group, 83.3% had grade I, 13.3% had grade II, and 3.3% had grade III. In McGrath group, 6 patients (20%) required more than 120 seconds to get intubated and only 73.3% were intubated in 1 attempt, while patients in Macintosh group had 100% successful intubation in 1 attempt. Pharyngeal trauma was seen with McGrath videolaryngoscopy. Conclusion. Duration of laryngoscopy, intubation, and total duration of intubation were significantly higher in McGrath group than in Macintosh group. McGrath group required a higher number of intubation attempts.
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Hur, Min, Jong Yeop Kim, Sang Kee Min, Kyuheok Lee, Young Ju Won, and Ji Eun Kim. "Comparison of McGrath Videolaryngoscope and Macintosh Laryngoscope in Children with Torticollis: Randomized Controlled Trial." Children 8, no. 12 (2021): 1171. http://dx.doi.org/10.3390/children8121171.

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We investigated the efficacy of the McGrath videolaryngoscope compared with the Macintosh laryngoscope in children with torticollis. Thirty children aged 1–10 years who underwent surgical release of torticollis were randomly assigned into the McGrath and Macintosh groups. Orotracheal intubation was performed by a skilled anesthesiologist. The primary outcome was the intubation time. The Cormack–Lehane grade, lifting force, intubation difficulty scale (IDS), difficulty level, and intubation failure rate were also assessed. The intubation time was significantly longer in the McGrath group than in the Macintosh group (31.4 ± 6.7 s vs. 26.1 ± 5.4 s, p = 0.025). Additionally, the Cormack–Lehane grades were comparable between the groups (p = 0.101). The lifting force and IDS were significantly lower in the McGrath group than in the Macintosh group (p < 0.001 and p = 0.022, respectively). No significant differences were observed with respect to endotracheal intubation difficulty and intubation success rate. Intubation-related complications were also not observed. In conclusion, compared with the Macintosh laryngoscope, the McGrath videolaryngoscope extended the intubation time and did not improve glottic visualization in children with torticollis, despite having a lesser lifting force, lower intubation difficulty scale, and similar success rate.
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Book chapters on the topic "Cormack - Lehane grade"

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"Video vs. Direct Laryngoscopy." In 50 Studies Every Anesthesiologist Should Know, edited by Anita Gupta, Elena N. Gutman, Michael E. Hochman, Anita Gupta, Elena N. Gutman, and Michael E. Hochman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190237691.003.0001.

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This chapter focuses on a randomized clinical trial asking the question: How does the GlideScope® Video Laryngoscope compare with direct laryngoscopy (DL) in terms of laryngoscopic view and time required for intubation? The study included adults electing surgery for which laryngoscopy was needed and excluded patients requiring rapid sequence induction or those with elevated intracranial pressure, known airway pathology, or cervical spine injury. In most patients, the GlideScope® yielded improved laryngoscopic views compared with DL, especially in the Cormack and Lehane grade 3 patients, demonstrating an advantage over DL for difficult intubations. This study was terminated early at 200 patients when the data demonstrated a difference in the GlideScope® view.
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Boedeker Ben H., Berg Benjamin W., Bernhagen Mary A., and Murray W. Bosseau. "Endotracheal Intubation Comparing a Prototype Storz CMAC and a GlideScope Videolaryngoscope in a Medical Transport Helicopter – A Pilot Study." In Studies in Health Technology and Informatics. IOS Press, 2009. https://doi.org/10.3233/978-1-58603-964-6-37.

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In this pilot study, experienced medical helicopter personnel evaluated and compared the prototype Storz CMAC and GlideScope (GS) videolaryngoscopes in intubating a Laerdal Difficult Airway Manikin in a helicopter. No significant differences were found between the devices in the standard airway mode with 100% success rates for the intubations. In the difficult airway mode, there was a significant difference (p = 0.03) between the Cormack Lehane scores observed with Direct View (DV) (3.75 ± 0.46 – average ± standard deviation) compared to the view with the prototype CMAC (2.25 ± 0.71). The view was 3.00 ± 0.76 with GS In the difficult airway, there were significantly more participants who obtained a Grade 1 or 2 view when using the CMAC compared to when using the Mac 3 blade (DV) (p = 0.025; Fisher Exact Probability Test). The success rate for intubating the difficult airway was 0% with DV; compared to 63% with the CMAC and 50% with the GS (p = 0.03). The participants answered a post study questionnaire regarding the characteristics of the devices and indicated preference for the CMAC over the GS in intubation of the difficult airway.
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Boedeker Ben H., Berg Benjamin W., Bernhagen Mary, and Murray W. Bosseau. "Endotracheal Intubation in a Medical Transport Helicopter – Comparing Direct Laryngoscopy with the Prototype Storz CMAC." In Studies in Health Technology and Informatics. IOS Press, 2009. https://doi.org/10.3233/978-1-58603-964-6-40.

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This pilot study examined backward intubation of the Laerdal Difficult Airway Manikin in a medical transport helicopter using the prototype (a new more compact) Storz CMAC videolaryngoscope. The standard manikin airway Cormack Lehane (CL) view scores were 2.00 ± 1.00 for direct view and 1.375 ± 0.517 for the indirect view (CMAC). Success rates for backward intubation in the standard airway were 100% (CMAC) and 87.5% (DV). Average CL grades in the difficult airway were 3.63 ± 0.74 (DV) and 2.00 ± 0.926 (CMAC)(p = 0.002). The success rates for backward intubation of the difficult airway were 12.5% (DV) and 63% (CMAC). Our results show that in backward intubation of the difficult airway in a helicopter setting, the prototype CMAC videolaryngoscope significantly improved the airway score by 1-2 grades and improved intubation success 5-fold. Studies using the portable CMAC videolaryngoscope under challenging rescue conditions and positions should be considered.
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Berg Benjamin W., Vincent Dale S., Murray W. Bosseau, and Boedeker Ben H. "Videolaryngoscopy for Intubation Skills Training of Novice Military Airway Managers." In Studies in Health Technology and Informatics. IOS Press, 2009. https://doi.org/10.3233/978-1-58603-964-6-34.

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An estimated 10% of preventable battlefield deaths are due to Airway obstruction. Improved airway rescue strategies are needed with new tools for airway management by less experienced providers. Airway management and training are improved using video laryngoscopy (VL) compared to direct laryngoscopy (DL). We evaluated if novices could rapidly acquire fundamental skills and compared intubation time and laryngeal visualization using VL compared to DL in a manikin model of normal laryngeal anatomy. For 43 subjects mean intubation time did not differ for DL (25.9 ± 24.5 seconds) vs. VL (26.4 ± 31.5 seconds) {p = 0.94 paired t-test}. Self reported novice intubation time was 6.82 ± 31.0 seconds greater with VL (31.6 ± 34.6 seconds) vs. DL (24.8 ± 18.5 seconds) {p = 0.255 paired t-test}. VL vs. DL time difference was not different between self-reported novice and non-novice groups. Mean Cormack-Lehane airway visualization grades (range 1–4) were higher with VL (1.95 ± 0.97) vs. DL (1.02 ± 0.15) {Students t-test p < 0.0001}. VL (69.7%) was preferred to DL (18.6%); no preference was indicated by 11.6%.
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Conference papers on the topic "Cormack - Lehane grade"

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Brown, W., M. W. Semler, D. R. Janz, et al. "Effect of Operator Experience on Cormack-Lehane Grade of View and First Pass Success During Tracheal Intubation in the ICU." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a1408.

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