Comparison of the laryngoscopy views with the size 1 Miller and Macintosh laryngoscope blades lifting the epiglottis or the base of the tongue in infants and children &lt;2 yr of age

Passi, Yuvesh; Sathyamoorthy, Madhankumar; Lerman, Jerrold; Heard, Christopher; Marino, Michael J.

doi:10.1093/bja/aeu228

Cited by 56 publications

(54 citation statements)

References 11 publications

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“…In contrast to other studies comparing experienced and inexperienced practitioners [6, 9–11, 19, 21, 22], this study demonstrated that TTV was similar between the groups. However, in this study, there were no institutional differences in FPA or TTV among the blades or airway scenarios.…”

Section: Discussioncontrasting

confidence: 99%

A comparison of two hyperangulated video laryngoscope blades to direct laryngoscopy in a simulated infant airway: a bicentric, comparative, randomized manikin study

et al. 2018

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BackgroundIn infants, securing the airway is time-critical because of anatomical and physiological differences related to airway management in children less than 1 year old. The aim of this study was to compare the time to ventilation using two different hyperangulated video laryngoscope blades with the time to ventilation via conventional direct laryngoscopy in a normal airway [NA] and in a simulated difficult airway [DA].MethodsThis study was a comparative, bicentric, open-label, randomized controlled evaluation. An infant high-fidelity simulator (SimBaby™; Laerdal® Medical, Stavanger, Norway) was used, and two scenarios were proposed, as follows: NA and DA evoked with tongue edema and cervical collar. After theoretical and practical briefing, each participant compared in the two airway scenarios the novel King Vision™ Pediatric aBlade (KV) (Ambu® A/S, Bad Nauheim, Germany) video laryngoscope and the C-MAC™ D-blade Ped (DB) (Karl Storz® SE & Co. KG, Tuttlingen, Germany) video laryngoscope to conventional laryngoscopy using the Miller Blade (MiB) and the Macintosh Blade (MaB) in a random sequence.ResultsEighty physicians (65 AN and 15 PCCM staff) were included. In the NA scenario, the median [IQR] time to successful time to ventilation (TTV) was significantly shorter for the KV at 13 s [12–15 s] than for the MaB at 14.5 s [13–16 s], DB at 14.5 s [13–16] and MiB at 16 s [14–19] (p < 0.001). In DA, the KV also shortened TTV to 14 s [13–16], whereas TTV was 23 s with the MaB [20–26], 19 s with the DB [16–21], and 27 s with the MiB [22–31] (p < 0.001). There were no differences in first-pass intubation success rates (FPAs) between hyperangulated blades and direct laryngoscopes in NA. In DA, the hyperangulated blades enabled 92 (DB) to 100% (KV) FPAs compared with 65 (MiB) to 76% (MaB) for conventional laryngoscopy (p < 0.001).ConclusionVideo laryngoscopes with hyperangulated blades were associated with shorter TTV in normal and difficult infant airway situations. The higher FPAs of hyperangulated blades in DA may avoid desaturations and decrease adverse events in pediatric airway management.Electronic supplementary materialThe online version of this article (10.1186/s12871-018-0580-y) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 99%

A comparison of two hyperangulated video laryngoscope blades to direct laryngoscopy in a simulated infant airway: a bicentric, comparative, randomized manikin study

et al. 2018

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“…Besides, a recently published article in BJA ‘Comparison of the laryngoscopy views with the size 1 Miller and Macintosh laryngoscope blades lifting the epiglottis or the base of the tongue in infants and children <2 year of age provides results similar to our study even though here the Miller blade was introduced from the right commissure of the mouth .…”

supporting

confidence: 85%

Reply to comments on our paper ‘Does the Miller blade truly provide a better laryngoscopic view and intubating conditions than the Macintosh blade in small children?’

Varghese

Kundu

2014

Pediatric Anesthesia

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“…The differences in infant's airway anatomy compared to an adult further add to it making airway management in lateral position in this age group challenging. Failure to successfully intubate the trachea and secure the child's airway can lead to significant morbidity and mortality in the operative setting . Despite being an important concern, surprisingly so far, there is very limited prospective data on airway management in lateral decubitus position.…”

Section: Introductionmentioning

confidence: 99%

Comparison of intubation conditions with CMAC Miller videolaryngoscope and conventional Miller laryngoscope in lateral position in infants: A prospective randomized trial

Jain

Mehta

Gandhi

et al. 2018

Pediatric Anesthesia

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Comparison of the laryngoscopy views with the size 1 Miller and Macintosh laryngoscope blades lifting the epiglottis or the base of the tongue in infants and children <2 yr of age

Abstract: NCT01717872 at Clinical Trials.gov.

Cited by 56 publications

References 11 publications

A comparison of two hyperangulated video laryngoscope blades to direct laryngoscopy in a simulated infant airway: a bicentric, comparative, randomized manikin study

A comparison of two hyperangulated video laryngoscope blades to direct laryngoscopy in a simulated infant airway: a bicentric, comparative, randomized manikin study

Reply to comments on our paper ‘Does the Miller blade truly provide a better laryngoscopic view and intubating conditions than the Macintosh blade in small children?’

Comparison of intubation conditions with CMAC Miller videolaryngoscope and conventional Miller laryngoscope in lateral position in infants: A prospective randomized trial

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