Comparison of conventional and videolaryngoscopy blades in neonates

Kirolos, Sandy; O’Shea, Joyce E

doi:10.1136/archdischild-2018-315644

Cited by 15 publications

(8 citation statements)

References 10 publications

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“…Although few studies have reported that chest compressions may not interrupt the intubation process (30,31), which is similar to the results of our study, it is important to reduce the risk of injury and relieve the stress of the intubator when continuous chest compressions are necessary. VL may improve the intubation time by providing a good view of the glottis compared with DL under the circumstances of uninterrupted chest compressions (32). These studies, including ours, reflect the performance of resuscitators or trainees in intubating manikins.…”

Section: Discussionmentioning

confidence: 66%

“…One-third of the trainees with intubation experience favored its use as a result of the minor adaptation of visualization for intubation. The blade of the video laryngoscope may be designed to minimize the possibility of intubation-associated injury since the vocal cord do not have to be visualized for intubation ( 33 ). This method may help operators predict the difficulty of intubation ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

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Video Laryngoscopy Improves the Success of Neonatal Tracheal Intubation for Novices but Not for Experienced Medical Staff

Zhou

et al. 2020

Front. Pediatr.

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Background: There is limited evidence on the use of video laryngoscopy (VL) in neonatal tracheal intubation (NTI) during neonatal resuscitation. In this study, we aimed to compare the difference between direct laryngoscopy (DL) and VL in NTI of trainees during neonatal resuscitation training. Materials and Methods: A prospective observational study was conducted during a neonatal resuscitation training course to examine three circumstances: NTI by experienced medical staff (EMS) and less-experienced medical staff (LEMS) in a neonatal resuscitation scenario; NTI by EMS and LEMS with an ongoing chest compression; and NTI by midwives who were novices in the procedure. The trainees were given scenarios or were shown demonstrations on newborn simulation manikins and were required to perform an NTI on a simulation manikin using DL and/or VL. The mean intubation time and success rate of intubation were measured. Results: The mean NTI time for EMS using VL (24.1 ± 7.2 s) was significantly longer than that using DL intubation (18.1 ± 6.9 s, P < 0.001), whereas there was no significant difference between using VL and DL for LEMS. EMS spent slightly less time on NTI than did LEMS using both VL and DL, but there were no statistically significant differences (both p > 0.05). The NTI success rate for EMS using VL (48.0%, 12/25) was significantly lower than that using DL (88.0%, 22/25, P = 0.004), while the NTI success rate for LEMS using VL (68.2%, 15/22 vs. 40.9%, 9/22) was higher than that using DL, but there was no statistical significance. When NTI was required with ongoing chest compressions, there was no significant difference in the mean NTI time and success rate between using VL and DL for EMS or LEMS. In the group of midwives who were novices in NTI, after they watched a demonstration teaching NTI, the intubation time using VL (19.6 ± 9.0 s) was significantly shorter than that using DL (28.0 ± 6.7 s, P < 0.001). The success rate of NTI using VL was significantly higher (96.2%; 25/26) than that using DL (69.2%; 18/26). Conclusion: The video laryngoscopy could be an effective training tool for inexperienced staff in developing the skill of tracheal intubation.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Video Laryngoscopy Improves the Success of Neonatal Tracheal Intubation for Novices but Not for Experienced Medical Staff

Zhou

et al. 2020

Front. Pediatr.

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“…In the case of difficult airway, when it is impossible to optimally visualize the entrance to the glottis, difficult intubation stylets can be helpful, allowing the intubation tube to be inserted into the trachea without the need to visualize it. Intubation with a Miller or Macintosh blade laryngoscope was insufficiently effective under difficult airway conditions and the duration of the procedure was prolonged as compared with intubation with the use of a stylet or videolaryngoscope [39–41].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial

Evrın

Smereka

Gorczyca

et al. 2019

Emergency Medicine International

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Introduction. Airway management is one of key elements of resuscitation. Endotracheal intubation is still considered the gold standard for airway management during resuscitation. Aim. The aim of the study was to compare success rates and intubation time of different endotracheal intubation methods during emergency intubation with difficult airways in the conditions of cardiopulmonary resuscitation in a standardized manikin model. Methods. The study was designed as a prospective, randomized, cross-over simulation study. It involved 46 paramedics with at least 5 years of experience in Emergency Medical Service. The participants performed endotracheal intubation under difficult airway conditions during continuous chest compression, implemented with the LUCAS3 chest compression system. Three methods of tracheal intubation were applied: (1) standard Macintosh laryngoscope without a bougie stylet; (2) standard laryngoscope and a standard bougie stylet; (3) standard laryngoscope and a new bougie stylet. Results. The overall intubation success rate was 100% in the standard bougie and new bougie groups and lower (86.9%) when no bougie stylet was used (P=0.028). The intubation success rate with the 1st attempt equalled 91.3% for the new bougie group, 73.9% for standard bougie, and only 23.9% in the no-bougie group. The median intubation time was shortest in the new bougie group, where it amounted to 29 s (interquartile range [IQR]: 25–38); the time equalled 38s (IQR:31–44.5) in the standard bougie group and 47.5s (IQR:36–58) in the no-bougie group. The ease of use was lowest in the no-bougie group (85, IQR:63–88), average in the standard bougie group (44, IQR:30–51), and highest in the new bougie stylet group (32, IQR:19–41). Conclusion. In this manikin-based study, paramedics were able to perform endotracheal intubation with higher efficacy and in a shorter time using the new bougie stylet as compared with the standard bougie stylet.

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“…Videolaryngoscope (VL) (35) and supraglottic airway devices (SAD) such as LMA (36) are increasingly used in neonates (37, 38) as companies develop equipment for use at lower gestations (39,40). LMA is recommended in the 2020 European Resuscitation Council (ERC) guidelines as an adjunct in infants of 34 weeks gestation or more (17).…”

Section: Other Airway Adjunctsmentioning

confidence: 99%

Management of the Unexpected Difficult Airway in Neonatal Resuscitation

et al. 2021

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A “difficult airway situation” arises whenever face mask ventilation, laryngoscopy, endotracheal intubation, or use of supraglottic device fail to secure ventilation. As bradycardia and cardiac arrest in the neonate are usually of respiratory origin, neonatal airway management remains a critical factor. Despite this, a well-defined in-house approach to the neonatal difficult airway is often lacking. While a recent guideline from the British Pediatric Society exists, and the Scottish NHS and Advanced Resuscitation of the Newborn Infant (ARNI) airway management algorithm was recently revised, there is no Norwegian national guideline for managing the unanticipated difficult airway in the delivery room (DR) and neonatal intensive care unit (NICU). Experience from anesthesiology is that a “difficult airway algorithm,” advance planning and routine practicing, prepares the resuscitation team to respond adequately to the technical and non-technical stress of a difficult airway situation. We learned from observing current approaches to advanced airway management in DR resuscitations in a university hospital and make recommendations on how the neonatal difficult airway may be managed through technical and non-technical approaches. Our recommendations mainly pertain to DR resuscitations but may be transferred to the NICU environment.

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Comparison of conventional and videolaryngoscopy blades in neonates

Cited by 15 publications

References 10 publications

Video Laryngoscopy Improves the Success of Neonatal Tracheal Intubation for Novices but Not for Experienced Medical Staff

Video Laryngoscopy Improves the Success of Neonatal Tracheal Intubation for Novices but Not for Experienced Medical Staff

Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial

Management of the Unexpected Difficult Airway in Neonatal Resuscitation

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