6/28/23, 9:54 PM EMMA Pathway Feedback Search Clinical Topics Home Studies EMMA EMMA Trial question Is McGrath Mac videolaryngoscopy superior to direct laryngoscopy in patients undergoing elective tracheal intubation? Study design Multi-center Open label RCT Population Characteristics of study participants 50.0% female N = 2092 50.0% male 2092 patients (1053 female, 1039 male) Inclusion criteria: adult patients without predicted difficult airway requiring tracheal intubation for elective surgery Key exclusion criteria: anticipated difficult airway with an airway difficulty score > 8; ASA physical status 4 or 5; BMI 40; increased risk of pulmonary aspiration; or pregnancy Interventions N=1053 McGrath videolaryngoscopy (use of McGrath videolaryngoscope with a size 3 or 4 Macintosh-based blade) N=1039 direct laryngoscopy (use of a standard laryngoscope with a size 3 or 4 Macintosh blade) Primary outcome First-pass tracheal intubation success 94.0 % 94 82 70.5 % 47.0 % Significant increase 23.5 % NNT = 8 0 0 % https://web.pathway.md/studies/rec73SIRIV5m5KGpq 1/2 6/28/23, 9:54 PM 0.0 % EMMA Pathway McGrath videolaryngoscopy Direct laryngoscopy Significant increase in first-pass tracheal intubation success (94% vs. 82%; AD 12.1%, 95% CI 10.9 to 13.6) Secondary outcomes Significant increase in overall success rate of tracheal intubation (99% vs. 96%; AD 3%, 95% CI 1.22 to 4.78) Significant increase in time to tracheal tube placement (22 seconds vs. 20 seconds; AD 2 seconds, 95% CI 0.81 to 3.19) Significant decrease in intubation difficulty score > 5 (1% vs. 6%; ARD -5, 95% CI -7.97 to -2.03) Conclusion In adult patients without predicted difficult airway requiring tracheal intubation for elective surgery, McGrath videolaryngoscopy was superior to direct laryngoscopy with respect to a first- pass tracheal intubation success. Reference M Kriege, R R Noppens, T Turkstra et al. A multicentre randomised controlled trial of the McGrath Mac videolaryngoscope versus conventional laryngoscopy. Anaesthesia. 2023 Jun;78(6):722-729. Open reference URL https://web.pathway.md/studies/rec73SIRIV5m5KGpq 2/2