Abstract:
BACKGROUND:In infants, securing the airway is time-critical because of anatomical and physiological differences related to airway management in children less than 1 year old. The aim of this study was to compare the time to ventilation using two different hyperangulated video laryngoscope blades with the time to ventilation via conventional direct laryngoscopy in a normal airway [NA] and in a simulated difficult airway [DA]. METHODS:This study was a comparative, bicentric, open-label, randomized controlled evaluation. An infant high-fidelity simulator (SimBaby™; Laerdal® Medical, Stavanger, Norway) was used, and two scenarios were proposed, as follows: NA and DA evoked with tongue edema and cervical collar. After theoretical and practical briefing, each participant compared in the two airway scenarios the novel King Vision™ Pediatric aBlade (KV) (Ambu® A/S, Bad Nauheim, Germany) video laryngoscope and the C-MAC™ D-blade Ped (DB) (Karl Storz® SE & Co. KG, Tuttlingen, Germany) video laryngoscope to conventional laryngoscopy using the Miller Blade (MiB) and the Macintosh Blade (MaB) in a random sequence. RESULTS:Eighty physicians (65 AN and 15 PCCM staff) were included. In the NA scenario, the median [IQR] time to successful time to ventilation (TTV) was significantly shorter for the KV at 13 s [12-15 s] than for the MaB at 14.5 s [13-16 s], DB at 14.5 s [13-16] and MiB at 16 s [14-19] (p < 0.001). In DA, the KV also shortened TTV to 14 s [13-16], whereas TTV was 23 s with the MaB [20-26], 19 s with the DB [16-21], and 27 s with the MiB [22-31] (p < 0.001). There were no differences in first-pass intubation success rates (FPAs) between hyperangulated blades and direct laryngoscopes in NA. In DA, the hyperangulated blades enabled 92 (DB) to 100% (KV) FPAs compared with 65 (MiB) to 76% (MaB) for conventional laryngoscopy (p < 0.001). CONCLUSION:Video laryngoscopes with hyperangulated blades were associated with shorter TTV in normal and difficult infant airway situations. The higher FPAs of hyperangulated blades in DA may avoid desaturations and decrease adverse events in pediatric airway management.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Kriege M,Pirlich N,Ott T,Wittenmeier E,Dette Fdoi
10.1186/s12871-018-0580-ysubject
Has Abstractpub_date
2018-08-31 00:00:00pages
119issue
1issn
1471-2253pii
10.1186/s12871-018-0580-yjournal_volume
18pub_type
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journal_title:BMC anesthesiology
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,评审
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更新日期:2018-11-06 00:00:00
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更新日期:2020-07-17 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2015-03-08 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-01-21 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2018-01-18 00:00:00
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abstract::An amendment to this paper has been published and can be accessed via the original article. ...
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pub_type: 已发布勘误
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更新日期:2020-11-09 00:00:00
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更新日期:2015-12-15 00:00:00
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