The efficacy of GlideScope ® videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate: An analysis from the paediatric difficult intubation registry

R. Park, J. M. Peyton, J. E. Fiadjoe, A. I. Hunyady, T. Kimball, D. Zurakowski, P. G. Kovatsis, A. Bosenberg, P. Hopkins, C. Glover, O. Olutoye, P. Szmuk, P. Olomu, N. Jagannathan, N. Burjek, S. Watkins, P. Reynolds, B. Haydar, M. Matuszczak, R. JainS. Khalil, D. Polaner, J. Zieg, J. Szolnoki, M. Sathyamoorthy, B. Taicher, S. Bhattacharya, V. Raman, T. Bhalla, P. Stricker, J. Lockman, J. Galvez, Mdm Rehman, A. Nishisaki, B. Von Ungern-Sternberg, D. Sommerfield, C. Soneru, F. Chiao, M. Richtsfeld, K. Belani, L. Sarmiento, S. Mireles, G. B. Rosas

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background We analysed data from the Paediatric Difficult Intubation Registry examining the use of direct laryngoscopy and GlideScope ® videolaryngoscopy. Methods Data collected by a multicentre, paediatric difficult intubation registry from 1295 patients were analysed. Rates of success and complications between direct laryngoscopy and GlideScope videolaryngoscopy were analysed. Results Initial (464/877 = 53% vs 33/828 = 4%, Z-Test = 22.2, P < 0.001) and eventual (720/877 = 82% vs. 174/828 = 21%, Z-Test = 25.2, P < 0.001) success rates for GlideScope were significantly higher than direct laryngoscopy. Children weighing <10 kg had lower success rates with the GlideScope than the group as a whole. There were no differences in complication rates per attempt between direct laryngoscopy and GlideScope. The direct laryngoscopy group had more complications associated with the greater number of attempts needed to intubate. There were no increased risks of hypoxia or trauma with GlideScope use. Each additional attempt at intubation with either device resulted in a two-fold increase in complications (odds ratio: 2.0, 95% confidence interval: 1.5-2.5, P < 0.001). Conclusions During difficult tracheal intubation in children, direct laryngoscopy is an overly used technique with a low chance of success. GlideScope use was associated with a higher chance of success with no increased risk of complications. GlideScope use in children with difficult tracheal intubation has a lower success rate than in adults with difficult tracheal intubation. Children weighing less than 10 kilograms had lower success rates with either device. Attempts should be minimized with either device to decrease complications.

Original languageEnglish (US)
Pages (from-to)984-992
Number of pages9
JournalBritish Journal of Anaesthesia
Volume119
Issue number5
DOIs
StatePublished - Nov 1 2017

Keywords

  • airway management
  • children
  • difficult intubation
  • intratracheal intubation
  • videolaryngoscopy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Park, R., Peyton, J. M., Fiadjoe, J. E., Hunyady, A. I., Kimball, T., Zurakowski, D., Kovatsis, P. G., Bosenberg, A., Hopkins, P., Glover, C., Olutoye, O., Szmuk, P., Olomu, P., Jagannathan, N., Burjek, N., Watkins, S., Reynolds, P., Haydar, B., Matuszczak, M., ... Rosas, G. B. (2017). The efficacy of GlideScope ® videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate: An analysis from the paediatric difficult intubation registry. British Journal of Anaesthesia, 119(5), 984-992. https://doi.org/10.1093/bja/aex344