The efficacy of GlideScope (R) 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; Paediatric Difficult Intubation (PeDI) Collaborative Investigators; Patrick N Olomu

doi:10.1093/bja/aex344

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The efficacy of GlideScope (R) videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate: an analysis from the paediatric difficult intubation registry

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The efficacy of GlideScope (R) 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, Paediatric Difficult Intubation (PeDI) Collaborative Investigators and Patrick N Olomu

British journal of anaesthesia : BJA, Vol.119(5), pp.984-992

11/01/2017

DOI: 10.1093/bja/aex344

PMID: 29028952

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Abstract

Background. We analysed data from the Paediatric Difficult Intubation Registry examining the use of direct laryngoscopy and GlideScope (R) 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.

Anesthesiology

Life Sciences & Biomedicine

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Title: Subtitle: The efficacy of GlideScope (R) videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate: an analysis from the paediatric difficult intubation registry
Creators: R. Park - Boston Children's Hospital
J. M. Peyton - Boston Children's Hospital
J. E. Fiadjoe - University of Pennsylvania
A. I. Hunyady - Seattle Children's Hospital
T. Kimball - Boston Children's Hospital
D. Zurakowski - Boston Children's Hospital
P. G. Kovatsis - Boston Children's Hospital
Paediatric Difficult Intubation (PeDI) Collaborative Investigators
Patrick N Olomu (Contributor) - Anesthesia
Resource Type: Journal article
Publication Details: British journal of anaesthesia : BJA, Vol.119(5), pp.984-992
DOI: 10.1093/bja/aex344
PMID: 29028952
NLM abbreviation: Br J Anaesth
ISSN: 0007-0912
eISSN: 1471-6771
Publisher: Elsevier
Number of pages: 9
Grant note: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
Language: English
Date published: 11/01/2017
Academic Unit: Anesthesia
Record Identifier: 9984656602502771

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