First-choice videolaryngoscopy for paediatric tracheal intubation.

Anaesthesia

Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China.

Published: December 2024

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Source
http://dx.doi.org/10.1111/anae.16419DOI Listing

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Routine Use of Videolaryngoscopy in Airway Management.

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October 2024

Department of Anaesthesia, St John's Hospital, NHS Lothian, Livingston, UK.

Article Synopsis
  • * The use of videolaryngoscopes has been shown to improve success rates in this procedure, leading to their growing adoption in international guidelines despite underuse in practice.
  • * Barriers such as training gaps, fears about losing skills in direct laryngoscopy, and costs hinder widespread adoption, but ongoing research and new techniques are encouraging better integration of videolaryngoscopy in routine care.
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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.

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Before completion of this study, there was insufficient evidence demonstrating the superiority of videolaryngoscopy compared with direct laryngoscopy for elective tracheal intubation. We hypothesised that using videolaryngoscopy for routine tracheal intubation would result in higher first-pass tracheal intubation success compared with direct laryngoscopy. In this multicentre randomised trial, 2092 adult patients without predicted difficult airway requiring tracheal intubation for elective surgery were allocated randomly to either videolaryngoscopy with a Macintosh blade (McGrath™) or direct laryngoscopy.

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