Non-Cochrane · intervention · PM42676689
Comparison of the Effectiveness of the C-MAC Versus the McGrath Videolaryngoscope for Adult Endotracheal Intubation in Clinical Patients, Simulated Patients, and Manikin Settings: A Systematic Review and Meta-analysis.
Dimou Evgenia, Aretha Diamanto, Beskou-Kontou Theano, et al. · Anesthesiology research and practice · 2026 · PubMed · doi:10.1155/anrp/1575867
Findings
Population Adult clinical patients undergoing endotracheal intubation
8 findings
| McGrath videolaryngoscope | C-MAC videolaryngoscope | First-pass intubation success Adult clinical patient studies · Random-effects model; Excluding studies with intubation time as primary outcome | OR 0.89 [0.45, 1.78] GRADE not reported 3 studies · 530 participants |
| McGrath videolaryngoscope | C-MAC videolaryngoscope | Time to intubation Adult clinical patient studies · Random-effects model | MD 9.59 [-1.35, 20.52] Very low Downgraded: imprecision, inconsistency, publication bias 6 studies · 780 participants |
| McGrath videolaryngoscope | C-MAC videolaryngoscope | First-pass intubation success Adult clinical patient studies · Fixed-effect model | OR 0.54 [0.36, 0.82] GRADE not reported 6 studies · 780 participants |
| McGrath videolaryngoscope | C-MAC videolaryngoscope | Time to intubation Adult clinical patient studies · Fixed-effect model; Excluding studies with first-pass success as primary outcome | MD 14.12 [10.10, 18.14] GRADE not reported 4 studies · 330 participants |
| McGrath videolaryngoscope | C-MAC videolaryngoscope | Time to intubation Adult clinical patient studies · Random-effects model; Excluding studies with first-pass success as primary outcome | MD 14.29 [3.81, 24.76] GRADE not reported 4 studies · 330 participants |
| McGrath videolaryngoscope | C-MAC videolaryngoscope | First-pass intubation success Adult clinical patient studies · Random-effects model | OR 0.54 [0.29, 1.01] Low Downgraded: imprecision, inconsistency 6 studies · 780 participants |
| McGrath videolaryngoscope | C-MAC videolaryngoscope | Time to intubation Adult clinical patient studies · Fixed-effect model | MD 7.40 [4.54, 10.26] GRADE not reported 6 studies · 780 participants |
| McGrath videolaryngoscope | C-MAC videolaryngoscope | First-pass intubation success Adult clinical patient studies · Fixed-effect model; Excluding studies with intubation time as primary outcome | OR 0.83 [0.49, 1.42] GRADE not reported 3 studies · 530 participants |
Included primary studies 9
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Akbas 2019 A Comparison of McGrath MAC Versus C-MAC Videolaryngoscopes in Morbidly Obese Patients Undergoing Bariatric Surgery: A Randomized,… DOI:10.1089/bari.2018.0052 | 2019 | this review only | First-pass intubation success; Time to intubation | not extracted yet |
| Gupta 2022 Comparison of C-MAC and McGrathMAC Videolaryngoscopes for Intubation in Patients with Normal Airway by Donned Anaesthesiologists Using an… PMID:35979971 | 2022 | this review only | First-pass intubation success; Time to intubation | not extracted yet |
| Kleine-Brueggeney 2016 Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway: a multicentre randomized controlled trial DOI:10.1093/bja/aew058 | 2016 | this review only | First-pass intubation success; Time to intubation | not extracted yet |
| Ng 2012 Randomized controlled trial comparing the McGrath videolaryngoscope with the C-MAC videolaryngoscope in intubating adult patients with… DOI:10.1093/bja/aes145 | 2012 | this review only | First-pass intubation success; Time to intubation | not extracted yet |
| Pieters 2016 Comparison of seven videolaryngoscopes with the Macintosh laryngoscope in manikins by experienced and novice personnel DOI:10.1111/anae.13413 | 2016 | this review only | not stated | not extracted yet |
| Shin 2016 Comparing McGRATH® MAC, C-MAC®, and Macintosh Laryngoscopes Operated by Medical Students: A Randomized, Crossover, Manikin Study DOI:10.1155/2016/8943931 | 2016 | this review only | not stated | not extracted yet |
| Vig 2021 Comparison of Mc Grath-MAC and C-MAC video laryngoscopes for intubation in a COVID simulated mannequin by novice users wearing face… PMID:34188630 | 2021 | this review only | not stated | not extracted yet |
| Yumul 2016 Comparison of three video laryngoscopy devices to direct laryngoscopy for intubating obese patients: a randomized controlled trial DOI:10.1016/j.jclinane.2015.12.042 | 2016 | this review only | First-pass intubation success; Time to intubation | not extracted yet |
| Zhang 2021 Comparing the first-attempt tracheal intubation success of the hyperangulated McGrath® X-blade vs the Macintosh-type CMAC… DOI:10.1007/s10877-021-00746-5 | 2021 | this review only | First-pass intubation success; Time to intubation | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult clinical patients undergoing endotracheal intubation, simulated-patient clinical scenarios, and manikin-based adult airway models | Adult clinical patients (n=780; 6 studies) pooled; manikin studies (3; 322 operators or datasets) summarized qualitatively; obesity (2), COVID-19 intubation box (1), normal or simulated difficult airway (3) |
| Intervention | Intubation with the C-MAC or McGrath videolaryngoscope | C-MAC and McGrath videolaryngoscopes (some studies also had other videolaryngoscopes or Macintosh arms) |
| Comparison | The alternative device (McGrath or C-MAC) | Direct comparison of C-MAC versus McGrath |
| Outcomes | Primary: first-pass intubation success, time to intubation; secondary: total intubation success, number of attempts, glottic view, optimization maneuvers, operator difficulty or preference, airway complications | First-pass intubation success (6 studies; n=780); time to intubation (6 studies; n=780); complications summarized narratively |
| Study designs | RCTs, prospective randomized studies, randomized crossover designs | 9 randomized studies (6 clinical RCTs, 3 manikin studies) |
| Timing | Not specified | Not specified |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | Yes | No | no |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Low | no |