Corrigendum to ‘Difficult tracheal intubation in neonates and infants. NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE): a prospective European multicentre observational study’ (Br J Anaesth 2021; 126: 1173–81)

An approach to difficult airway in infants: Comparison of GlideScope® Spectrum LoPro, GlideScope® Spectrum Miller and conventional Macintosh and Miller blades in a simulated Pierre Robin sequence performed by 90 anesthesiologists

“…In 1.35% of those patients, laryngoscopy was difficult, which was defined as Cormack-Lehane (CL) view III and IV [ 1 ]. These findings are supported by current data of the NECTARINE network, describing an incidence of 5.8% difficult intubations in 4683 cases, defining difficult intubations as two failed attempts using direct laryngoscopy [ 2 , 3 ]. In recent years, the management of the difficult airway has been significantly simplified through the introduction of videolaryngoscopes in adult [ 6 ] and pediatric patients [ 7 , 8 ].…”

“…Neonates and infants are at higher risk for respiratory and cardiovascular complications during anesthesia induction and tracheal intubation than older children. The incidence of hypoxemia with subsequent bradycardia during intubation is significantly increased due to low functional residual capacity, small closing capacity, and higher oxygen consumption [ 2 , 3 , 17 ]. Difficult laryngoscopy and intubation can occur more frequently in neonates and infants, even in the absence of risk factors for a difficult airway and is often difficult to anticipate preoperatively [ 2 , 3 , 17 ].…”

“…In an infantile difficult airway situation, the early use of videolaryngoscopy and the timley switch to alternative techniques to secure the airway in case of failed tracheal intubation with a conventional laryngoscope can make a decisive contribution to avoiding cardiorespiratory complications. It is crucial to avoid repeated attempts at intubation in patients of this age group [ 2 , 3 , 17 – 19 ].…”

“…Prolonged intubation attempts in newborns and infants are associated with an increased rate of perioperative complications [ 2 , 3 , 5 ]. Physicians must be educated and trained specifically in airway management in high-risk patient groups [ 11 ].…”