Conventional Direct Laryngoscopy versus Videolaryngoscopy with the GlideScope^®: A Neonatal Manikin Study with Inexperienced Intubators

Abstract

We hypothesized that because the view of the glottis is better with videolaryngoscopes, successful intubation in neonates would be accomplished in a shorter time with the GlideScope (®) (Verathon, Inc., Bothell, WA) videolaryngoscope (GVL). Forty-five students of the University of Athens, inexperienced in both techniques, participated in the study (21 medical students and 24 nursing students, crossover randomized study). Following a brief educational session, each participant practiced and attempted intubation on a neonatal manikin using conventional laryngoscope and GVL, as many times as required to secure the airway. The time required to successful intubation and the number of attempts with each device were recorded. No significant difference was observed between the number of attempts required for successful intubation with either laryngoscope. The time required for the first successful intubation with the conventional laryngoscope was significantly shorter compared with that required with the GVL ( P = 0.0013). There was no difference regarding the time required for the successful intubation between medical and nursing students, using the conventional laryngoscope or the GVL. The number of attempts to successful intubation with either device did not differ. The time required for intubation with the GVL was longer, and this is probably due to a design flaw.

A Prospective Randomized Equivalence Trial of the GlideScope Cobalt® Video Laryngoscope to Traditional Direct Laryngoscopy in Neonates and Infants

“…Recently there has been a proliferation of new devices marketed for infant use; however, many of these represent scaled-down versions of their adult counterparts. 8 The different airway anatomy found in neonates and infants mandates rigorous examination of these designs before widespread use. This study compared intubation time using the infant GCV with DL.…”

“…The camera and display facilitate guidance of a novice laryngoscopist and provide confidence to the supervising physician that the endotracheal tube is placed correctly. Much of the available literature on video laryngoscopy in children examines manikins, [1][2][3] focuses on older children, 4 -7 studies inexperienced laryngoscopists, 3,8 or describes single patient experiences. 9 -12 Recent publications examining older children demonstrate that the GlideScope may offer improvements in intu-bation over traditional direct laryngoscopy.…”

“…1,3,4,18 -20 Some of these investigations are confounded by the use of novices as the intubators. 8 We conducted this single-site prospective randomized evaluation to compare intubation times of the GCV with DL in an infant population with normal airway anatomy. Our primary hypothesis was that intubation times with GCV would be similar (noninferior) to those with DL in experienced hands.…”

Do you see what I see? A randomised pilot study to evaluate the effectiveness and efficiency of simulation-based training with videolaryngoscopy for neonatal intubation

“…Sylvia et al 23 performed a randomised trial of paediatric intubation for emergency medicine providers using either DL or VL with no additional benefit conferred by the latter. Others have studied intubation performance of paediatric residents24 and students25 using VL and found no improvement in success rates over DL.…”

Learning Curve of the Infant GlideScope® Cobalt Video Laryngoscope in Anesthesiology Residents

“…A recent study in adults revealed the learning curve for anesthesiology residents using the Airtraq® was faster than that for the Macintosh laryngoscope [2]. Other studies have evaluated the use of the Cobalt GlideScope® in manikins [3,4]. The purpose of this study is to evaluate the learning curve associated with the use of the Infant GCV by novice users, as compared to direct laryngoscopy for intubation of infants weighing 10 kg or less.…”