Journal article
Videolaryngoscopy versus Fiber-optic Intubation through a Supraglottic Airway in Children with a Difficult Airway An Analysis from the Multicenter Pediatric Difficult Intubation Registry
Anesthesiology (Philadelphia), Vol.127(3), pp.432-440
09/01/2017
DOI: 10.1097/ALN.0000000000001758
PMID: 28650415
Abstract
Background: The success rates and related complications of various techniques for intubation in children with difficult airways remain unknown. The primary aim of this study is to compare the success rates of fiber-optic intubation via supraglottic airway to videolaryngoscopy in children with difficult airways. Our secondary aim is to compare the complication rates of these techniques.
Methods: Observational data were collected from 14 sites after management of difficult pediatric airways. Patient age, intubation technique, success per attempt, use of continuous ventilation, and complications were recorded for each case. First-attempt success and complications were compared in subjects managed with fiber-optic intubation via supraglottic airway and videolaryngoscopy.
Results: Fiber-optic intubation via supraglottic airway and videolaryngoscopy had similar first-attempt success rates (67 of 114, 59% vs. 404 of 786, 51%; odds ratio 1.35; 95% CI, 0.91 to 2.00; P = 0.16). In subjects less than 1 yr old, fiber-optic intubation via supraglottic airway was more successful on the first attempt than videolaryngoscopy (19 of 35, 54% vs. 79 of 220, 36%; odds ratio, 2.12; 95% CI, 1.04 to 4.31; P = 0.042). Complication rates were similar in the two groups (20 vs. 13%; P = 0.096). The incidence of hypoxemia was lower when continuous ventilation through the supraglottic airway was used throughout the fiber-optic intubation attempt.
Conclusions: In this nonrandomized study, first-attempt success rates were similar for fiber-optic intubation via supraglottic airway and videolaryngoscopy. Fiber-optic intubation via supraglottic airway is associated with higher first-attempt success than videolaryngoscopy in infants with difficult airways. Continuous ventilation through the supraglottic airway during fiber-optic intubation attempts may lower the incidence of hypoxemia.
Details
- Title: Subtitle
- Videolaryngoscopy versus Fiber-optic Intubation through a Supraglottic Airway in Children with a Difficult Airway An Analysis from the Multicenter Pediatric Difficult Intubation Registry
- Creators
- Nicholas E. Burjek - Northwestern UniversityAkira Nishisaki - Children's Hospital of PhiladelphiaJohn E. Fiadjoe - Children's Hospital of PhiladelphiaH. Daniel Adams - Florida Atlantic UniversityKenneth N. Peeples - Children's Hospital of PhiladelphiaVidya T. Raman - Nationwide Children's HospitalPatrick N. Olomu - The University of Texas Southwestern Medical CenterPete G. KovatsisNarasimhan Jagannathan - Lurie Children's HospitalPeDI Collaborative Investigators
- Resource Type
- Journal article
- Publication Details
- Anesthesiology (Philadelphia), Vol.127(3), pp.432-440
- DOI
- 10.1097/ALN.0000000000001758
- PMID
- 28650415
- NLM abbreviation
- Anesthesiology
- ISSN
- 0003-3022
- eISSN
- 1528-1175
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Grant note
- 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
- 09/01/2017
- Academic Unit
- Anesthesia
- Record Identifier
- 9984656530002771
Metrics
7 Record Views