The D-BLADE: a Significantly Modified Blade for the Storz
C-MAC Videolaryngoscopy System
Schirin M. Missaghi, MD1,
Ernst Zadrobilek, MD2
Anesthetist and Intensive Care Physician, Department of Anesthesia
and Intensive Care, Empress Elisabeth Hospital of the City of
Vienna, Vienna, Austria.
of Anesthesia and Intensive Care, Chairman of the Austrian Working
Group for Airway Management,
Address correspondence and comments to
Schirin M. Missaghi.
Received from the Department
of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of
Vienna, Vienna, Austria.
November 6, 2010.
The correct citation of this
communiction of new equipment and techniques is:
Missaghi SM, Krasser
K, Zadrobilek E. The D-BLADE: a significantly modified blade for the Storz
C-MAC Videolaryngoscopy System. Internet Journal of Airway Management
Available from URL:
Date accessed: month day, year.
updated: January 30, 2011.
The original blades for the C-MAC Videolaryngoscopy System (CMAC;
manufactured by Karl Storz Endoscopy, Tuttlingen, Germany) are similar in
design to standard Macintosh laryngoscopes. The manufacturer of
the CMAC recently launched the
D-BLADE Video Laryngoscope Blade (DVL) with a significantly modified
blade curvature; D stands for Volker Doerges (anesthetist in
Kiel, Germany) as co-inventor of the DVL.
The CMAC blades incorporate a digital camera and a
diode and are
connnected with an ergonomically designed laryngoscope
handle. The image on the distal lens is acquired using complementary
metal oxide semiconductor technology which guarantees a field of
vision extended to 80 grades and contributes to the prevention of
fogging. The light supplied is based on light-emitting diode
technology. The electronics module (plugged into the receptacle of
the laryngoscope handle) is the interface via a power cord/video
cable between the CMAC blade and the video unit. The magnified color image is
displayed on a high-resolution, thin-film transistor video monitor;
the white balance is performed automatically (with the option of
manual white balance) and the brightness can be adapted to light or
dark surroundings. The video unit is powered by rechargeable
lithium-ion batteries (operating for approximately 120 minutes when
fully charged). Video sequences and still images can be stored on a
secure digital memory card with an USB port for data transfer and
futher processing (integrated in the video unit).
Because of ease handling using the familiar
Macintosh-laryngoscopy technique with indirect lifting of the
epiglottis, portability, and provision of a wide
visual view of laryngeal structures, the CMAC may be a
suitable alternative device for routine and difficult
laryngoscopy and tracheal intubation; unfortunately, there are only
two published studies
available on the use of the original CMAC blades in patients
with apparently normal and simulated difficult airways (1,
to the original CMAC blades, the DVL, currently available only
in one size for use in adult patients, is characterized by a
pronounced elliptical curvature with the distal end facing
distinctly upwards. These features of the DVL may further improve
the laryngeal views particularly
in patients with difficult conventional laryngoscopy; this suggestion
is supported by a recently published case series including
patients with routine and difficult tracheal
and received an offer for the CMAC and the DVL from the Austrian division of Karl Storz Endoscopy. Economic considerations are usually provided by this journal
but the product manager did not allow us to communicate this information.
Byhahn C, Iber T, Zacharowski K, Weber CF, Ruesseler M, Schalk
R, Meininger D. Tracheal intubation using the mobile C-MAC video
laryngoscope for patients with a simulated difficult airway.
Cavus E, Kieckhaefer J, Doerges V, Moeller T, Thee C, Wagner K.
The C-MAC videolaryngoscope: first experiences with a new device
for videolarynoscopy-guided intubation.
Anesth Analg 110:473-477, 2010.
Cavus E, Neumann T, Doerges V, Moeller T, Scharf E, Wagner K,
Bein B, Serocki G. First clinical evaluation of the C-MAC
D-Blade videolaryngoscope during routine and difficult
Anesth Analg 112:382-385, 2011.