1Associate Professor of Anesthesia and Intensive Care, Chairman of the Austrian Working Group for Airway Management and Director of the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.
Address correspondence and comments to Ernst Zadrobilek.
Department of Anesthesia
and Intensive Care, Empress Elisabeth Hospital
of the City of Vienna, Vienna, Austria.
Received from the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.
Published: June 30, 2007.
Published: June 30, 2007.
The correct citation of this communiction of new equipment and techniques is:
Zadrobilek E. The GlideScope Cobalt Video Laryngoscope with a
disposable blade. Internet Journal of Airway Management
Last updated: July 28, 2007.
The various models and systems of the GlideScope Video Laryngoscope (GVL; manufactured by Verathon Medical, Bothell, Washington, United States) allow for the transmission of a color video image to a monitor, enabling the operator to visualize anatomical structures of the laryngeal aperture not necessarily in the line-of-sight with conventional laryngoscopy (1-3). Recently, the manufacturer released a new GVL model [the GlideScope Cobalt Video Laryngoscope (GCVL)] with a handle and video baton (including the camera system and light emitting diodes) for use with dedicated disposable laryngoscope blades (DLBs) together with the battery-powered, portable monitor of the Portable GlideScope Video Laryngoscope System (PGVL).
The DLBs are available in two sizes (for small and large adults, with a maximum thickness of 16.5 mm and lengths of 80 and 95 mm from the tip of the blades to the blade handles, respectively) and supplied in sterile packaging, ready for use. There is now no need to wait for hygienic reprocessing of the GVL blade between uses, ideal for institutions with a high GVL usage rate. The use of an automatic endoscopy washing machine became standard for reliable hygienic reprocessing of compact GVL blades at our institution, consuming up to 50 minutes (and incorporating the potential risk for damage of the camera system included in the blades), limiting the availability of the GVL unless at least one separate blade is provided.
The DBLs prevents contact of the GCVL with the patient; the handle of the GCVL is also covered by the DLBs. This offers a potential advantage with respect to reduced disease transmission, and thus follows the current trend of using disposable medical devices whenever possible. The DBLs (with a 60-degree upward angulation) are significantly modified compared to the blades of the compact GVLs. Unfortunately, there are currently no studies on the clinical use and performance of the GCVL.
Preliminary personal experiences with the GCVL in clinical practice indicate, that the GCVL also provides a panoramic view of laryngeal structures when properly inserted. Using the Schroeder directional tracheal tube stylet (Parker Flex-It, Parker Medical, Englewood, Colorado, United States) for articulating and passage of the tracheal tube through the laryngeal aperture, GCVL-assisted orotracheal intubation was successful at the first attempt in a series of 20 patients with a wide range of conventional laryngoscopic view grading. Because of the thickness and design of the DBLs, ease and performance of laryngoscopy and tracheal intubation with the GCVL may be located between those with the former standard and the more favorable lower-profile GVL.
The acquisition costs of the GCVL (together with the PGVL) and the replacement costs of the GCVL are about 10700 and 4500 Euro (exclusive value-added taxes, according to the offer of the Austrian distributor, queried in July 2007), respectively; the costs of the DBLs are about 28 Euro.
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