A Videolaryngoscopy Technique for the Intubation of the Newborn: Preliminary Report

Vanderhal, Andre; Berci, George; Simmons, Charles F.; Hagiike, Masanobu

doi:10.1542/peds.2008-3653

Cited by 50 publications

(46 citation statements)

References 15 publications

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“…Videolaryngoscopy has shown its clinical usefulness in infants as small as 530 g [44]. Videolaryngoscopy incorporates a fiberoptic camera lens into the light source of a laryngoscope blade, effectively positioning the laryngoscopist's eye at the tip of the blade, expanding the viewing angle offered by the direct laryngoscope [45].…”

Section: Alternative Methods Of Intubating Neonatesmentioning

confidence: 99%

Improving neonatal intubation safety: A journey of a thousand miles

Sawyer

Foglia

Hatch

et al. 2017

NPM

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Abstract. Neonatal intubation is one of the most common procedures performed by neonatologists, however, the procedure is difficult and high risk. Neonates who endure the procedure often experience adverse events, including bradycardia and severe oxygen desaturations. Because of low first attempt success rates, neonates are often subjected to multiple intubation attempts before the endotracheal tube is successfully placed. These factors conspire to make intubation one of the most dangerous procedures in neonatal medicine. In this commentary we review key elements in the journey to improve neonatal intubation safety. We begin with a review of intubation success rates and complications. Then, we discuss the importance of intubation training. Next, we examine quality improvement efforts and patient safety research to improve neonatal intubation safety. Finally, we evaluate new tools which may improve success rates, and decrease complications during neonatal intubation.

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Section: Alternative Methods Of Intubating Neonatesmentioning

confidence: 99%

Improving neonatal intubation safety: A journey of a thousand miles

Sawyer

Foglia

Hatch

et al. 2017

NPM

View full text Add to dashboard Cite

show abstract

“…For larger infants, both instruments produce a very useful image and can facilitate intubation when used by experienced operators. 76 Environment All of the above interventions can be better accomplished in an environment conducive to critical care. The resuscitation suite should be thought of as a place where the very best equipment is needed.…”

Section: Intubationmentioning

confidence: 99%

Neonatal resuscitation for the preterm infant: evidence versus practice

Finer

Rich

2010

J Perinatol

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In an effort to determine the actual conduct of neonatal resuscitation and the errors that may be occurring during this process, we developed a method of video recording neonatal resuscitations as an ongoing quality assurance project. We initiated video recordings of resuscitations using simple video recorders attached to an overhead warmer and reviewed the resultant tapes during biweekly quality improvement meetings. We also added the continuous recording of analog information such as heart rate, oximeter values, fraction of inspired oxygen and airway pressure. We subsequently developed a checklist that includes a preresuscitation briefing and a postresuscitation debriefing, all of which are reviewed at the same time as the video recording. We have examined the use of oxygen in the very preterm infant, the effectiveness of bag and mask ventilation, including the detection of airway obstruction during such ventilation, intubation in the delivery area and environment. In addition, we have trained our teams and leaders using Crew Resource Management and focused on improved communication. The availability of a dedicated room for resuscitation allows an increased ambient environment and the ability to provide a userfriendly setting similar to the neonatal intensive care unit to optimize performance. There are numerous opportunities for improving team and leader performance and outcomes following neonatal resuscitation. Further prospective studies are required to evaluate specific interventions.

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“…16 Video-assisted intubation is increasingly recognized as the method of choice in teaching ETI because of the magnified view it offers simultaneously to both trainees and supervisors. 17 Mannequin studies have reported improved success rates of ETI and decreased time to intubation with the VL. [18][19][20] Clinical studies are limited to preliminary experience where infants as small as 530 g were intubated with the VL.…”

mentioning

confidence: 99%

“…[18][19][20] Clinical studies are limited to preliminary experience where infants as small as 530 g were intubated with the VL. 17 To the best of our knowledge, there are no published human studies comparing VL to CL for acquiring the skill of neonatal ETI in the NICU. 21 This study aimed to assess whether VL is superior to CL in acquiring skill in neonatal ETI in the NICU and whether the skill acquired with the VL is transferable to use of the CL.…”

mentioning

confidence: 99%

Videolaryngoscope for Teaching Neonatal Endotracheal Intubation: A Randomized Controlled Trial

et al. 2016

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OBJECTIVE: To assess whether the videolaryngoscope (VL) is superior to the classic laryngoscope (CL) in acquiring skill in neonatal endotracheal intubation (ETI) and, once acquired with the VL, whether the skill is transferable to the CL. METHODS:This randomized controlled trial, in a level 3 Canadian hospital, recruited junior pediatric residents who performed ETI in the NICU. The primary outcome was success rate of ETI. Secondary outcomes were time to successful intubation, number of bradycardia episodes andlowest oxygen saturation during procedure, occurrence of mucosal trauma, reason for ETI failure, and recognition of problems related to ETI bysupervisor andresident. RESULTS:In phase 1, 34 pediatric residents performed 213 ETIs by using either VL or CL. Intervention groups were comparable at baseline. The success rate was higher (75.2% vs 63.4%, P = .03), and time to successful intubation was longer, inVL group (57 vs 47 seconds, P = .008). In phase 2, 23 residents performed 55 ETIs using CL. The success rate of residents inVL group performing ETI by using the CL was 63% (compared with 75% in phase 1, P = .16). CONCLUSIONS:When learning ETI, the success rate is improved with the VL. Time to successful intubation is longer, but the difference is not clinically significant. When switched to the CL, residents' success rate slightly decreased, but not significantly. This suggests that residents retain a certain level of ETI skill when switched to the CL. The VL is a promising tool for teaching neonatal ETI.

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A Videolaryngoscopy Technique for the Intubation of the Newborn: Preliminary Report

Abstract: This new technique and technology show promise to improve airway management, evaluation, and teaching. Future research to validate improved intubation success in difficult airways and in teaching situations is warranted.

Cited by 50 publications

References 15 publications

Improving neonatal intubation safety: A journey of a thousand miles

Improving neonatal intubation safety: A journey of a thousand miles

Neonatal resuscitation for the preterm infant: evidence versus practice

Videolaryngoscope for Teaching Neonatal Endotracheal Intubation: A Randomized Controlled Trial

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