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Prospective development and validation of a universal classification for paediatric videolaryngoscopic tracheal intubation: the PeDiAC score.
Anaesthesia
November 2024
Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Background: The VIDIAC score, a prospectively developed universal classification for videolaryngoscopy, has shown excellent diagnostic performance in adults. However, there is no reliable classification system for videolaryngoscopic tracheal intubation in children. We aimed to develop and validate a multivariable logistic regression model and easy-to-use score to classify difficult videolaryngoscopic tracheal intubation in children and to compare it with the Cormack and Lehane classification.
View Article and Find Full Text PDFArticle Synopsis
- Universal use of Storz C-MAC® videolaryngoscopes for adult tracheal intubations was adopted at Royal United Hospitals Bath NHS Foundation Trust in 2017, covering various medical settings, and data was collected from 1,099 procedures between March 2020 and March 2022.
- The overall intubation success rate was 100%, with a first-pass success rate of 87.3%, varying by device type and user experience, and 87% of attempts resulted in no complications, particularly high in operating theatres and the emergency department.
- Complications were rare, occurring in only 0.6% of cases, primarily outside theatres and during rapid sequence induction, highlighting the impact of
First-attempt awake tracheal intubation success rate using a hyperangulated unchannelled videolaryngoscope vs. a channelled videolaryngoscope in patients with anticipated difficult airway: a randomised controlled trial.
Anaesthesia
November 2024
Preventive Medicine and Public Health Unit, Department of Health Sciences, University of A Coruña-INIBIC, A Coruña, Spain.
Article Synopsis
- There is a lack of consensus on the best videolaryngoscope for awake tracheal intubation in patients expected to have difficult airways, leading to a study comparing the C-MAC D-Blade® and Airtraq®.
- A randomized clinical trial involved 90 adult patients undergoing surgery with anticipated difficult airways, focusing on the first-attempt tracheal intubation success rate as the primary outcome.
- Results showed a significantly higher first-attempt success rate for the C-MAC D-Blade (84%) compared to the Airtraq (62%), while overall success rates were similar for both, suggesting the C-MAC D-Blade may be more effective for initial intubation attempts.
Universal paediatric videolaryngoscopy and glottic view grading: a prospective observational study.
Anaesthesia
October 2024
Department of Anaesthesiology, Centre for Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Background: Although videolaryngoscopy has been proposed as a default technique for tracheal intubation in children, published evidence on universal videolaryngoscopy implementation programmes is scarce. We aimed to determine if universal, first-choice videolaryngoscopy reduces the incidence of restricted glottic views and to determine the diagnostic performance of the Cormack and Lehane classification to discriminate between easy and difficult videolaryngoscopic tracheal intubations in children.
Methods: We conducted a prospective observational study within a structured universal videolaryngoscopy implementation programme.
Hyperangulated vs. Macintosh videolaryngoscopy in adults with anticipated difficult airway management: a randomised controlled trial.
Anaesthesia
September 2024
Department of Anaesthesiology, Centre for Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Background: It is not certain whether the blade geometry of videolaryngoscopes, either a hyperangulated or Macintosh shape, affects glottic view, success rate and/or tracheal intubation time in patients with expected difficult airways. We hypothesised that using a hyperangulated videolaryngoscope blade would visualise a higher percentage of glottic opening compared with a Macintosh videolaryngoscope blade in patients with expected difficult airways.
Methods: We conducted an open-label, patient-blinded, randomised controlled trial in adult patients scheduled to undergo elective ear, nose and throat or oral and maxillofacial surgery, who were anticipated to have a difficult airway.
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