The difficult pediatric airway – a review of new devices for indirect laryngoscopy in children younger than two years of age

Holm-Knudsen, Rolf

doi:10.1111/j.1460-9592.2010.03487.x

Cited by 92 publications

(81 citation statements)

References 16 publications

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“…Multiple airway devices have been developed to improve the success and safety of intubation, however, reports of their use in neonates has been limited to case reports [38][39][40] observational studies [41] and small pilot randomized trials [42,43]. Clinical use of some technologies has been limited by the small size of the mouth and airway of the neonate.…”

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

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“…As acquisition costs decrease over time, moreover, these devices will become increasingly popular (69,70). It can be predicted that the next logical step in the evolution of the videolaryngoscopy will be for use in patients with a normal airway as a replacement for direct laryngoscopy (12,13,71). I believe that with increasing use of videolaryngoscopy in clinical airway management, its potential benefits of patients will be numerous and significant.…”

Section: Discussionmentioning

confidence: 99%

“…As yet, there are more than 10 commercial videolaryngoscopes availably, with the number constantly increasing and many existing devices being modified (Table and Figure 1). Most of currently available videolaryngoscopes can be broadly classified into the following four groups, with possible advantages and disadvantages (13)(14)(15)(16)(17)(18).…”

Section: Types Of Videolaryngoscopesmentioning

confidence: 99%

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Videolaryngoscopy Assisted Intubation — New Era for Airway Management

Xue¹,

Liu²,

Li³

et al. 2016

J Anesth Perioper Med

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Aim of review:The aim of this article is to review the recent literatures regarding videolaryngoscopes, compare performance of videolaryngoscopy versus direct laryngoscopy, discuss the role of videolaryngoscopy in clinical airway management and provide the measures that can improve the performance of videolaryngoscopy and decrease complications associated with videolaryngoscopy. Methods: The literatures about the use of videolaryngoscopes in the clinical airway management, published in the past decades, were searched from the Pubmed and Cochrane databases and reviewed, in order to determine their performance, and identify their limitations and find appropriate alternate techniques to overcome their shortcomings and failures. Recent findings: Videolaryngoscopes are promising intubation devices, which are easy to use, and the skills involved are easy to obtain by either novices or experienced intubators. In the current practice, videolaryngoscopes are commonly used as main devices of predicted difficult airways and as rescue tools of difficult or failed direct laryngoscopy. For patients with difficult airways, videolaryngoscopy can provide an improved laryngeal visualization and achieve a higher intubation success rate compared with direct laryngoscopy. Moreover, videolaryngoscopy has the potential to increase patient safety by facilitating learning, teaching, and success of tracheal intubation. Despite the very good laryngeal visualization, the insertion and advancement of the tracheal tube with videolaryngoscopy may occasionally fail, and the airway injuries associated with videolaryngoscopy can occur. Summary: The introduction of videolaryngoscopy has resulted in a dramatic transformation of clinical airway management and is seen as the evolutionary step in intubation technology. There are several different types of videolaryngoscopes available. Each device's features may offer advantages or disadvantages, depending on the situation the anesthetist has to deal with. To get the best out of videolaryngoscopy, all anesthetists must be trained in the use of videolaryngoscopes and such devices should be available in all sites where tracheal intubation is performed.

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“…There are various video laryngoscopic devices such as Malleable video-optical intubation stylet (VOIS) [9,10], Glidescope ® video laryngoscope, [11,12] AIRTRAQ ® Disposable Optical Laryngoscope, Truview PCD TM , [12] and Storz's pediatric video laryngoscope ( Figure 1). We studied the latter because of the extensive use of a straight blade laryngoscope in intubating infants and children.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Direct and Video Assisted Views of the Larynx during Routine Intubation in Infants and Children

Chhibber¹

2014

J Anesth Clin Res

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Purpose: Video assisted laryngoscopy has been rapidly incorporated into the anesthesiologist's arsenal for challenging adult airway management. The development of pediatric video airway equipment presents an opportunity to expand upon the previous reliance on direct laryngoscopy alone. This study utilized the Storz DCI ® Video Laryngoscope which consists of a standard straight 0 and 1 blade combined with a 2.8 mm fiberoptic light bundle built into the left side of the blade. Method:The ease of use, best direct and video-assisted glottic view was documented for 50 infants and children less than 2 years of age. Direct laryngoscopy was performed with the naked eye (direct view). The best views obtained with and without external laryngeal manipulation were graded by the laryngoscopist without looking at the video monitor. The views on the video monitor, located in front of the intubator and to the right of the patient, were simultaneously graded independently by another pediatric anesthesiologist.Results: Fifty infants and children, ages ranging from one day to 22 months, were enrolled in the study. There were 37 males, and 13 females. The average age was 10.5 months. ASA physical status ranged from I to III, with the vast majority of patients being either class I or II. The grade of laryngeal view on the video monitor was significantly improved when compared with that of direct laryngoscopy (p<0.05). Conclusion:In our study the view on the monitor screen was, on average, one grade better than the direct view. In only one instance was the view obtained with the video laryngoscope worse than that obtained under direct vision. The magnified view provided by the video laryngoscope allows for better visualization of airway structures in difficult airways and further help in facilitating securing the airway.

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The difficult pediatric airway – a review of new devices for indirect laryngoscopy in children younger than two years of age

Cited by 92 publications

References 16 publications

Improving neonatal intubation safety: A journey of a thousand miles

Improving neonatal intubation safety: A journey of a thousand miles

Videolaryngoscopy Assisted Intubation — New Era for Airway Management

Comparison of Direct and Video Assisted Views of the Larynx during Routine Intubation in Infants and Children

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