The Comparison of Direct Laryngoscopy and Video Laryngoscopy in Pediatric Airways Management for Congenital Heart Surgery: A Randomized Clinical Trial.
Airway Management
Children Congenital Heart Disease
Direct Laryngoscopy
Video Laryngoscopy
Journal
Anesthesiology and pain medicine
ISSN: 2228-7523
Titre abrégé: Anesth Pain Med
Pays: Netherlands
ID NLM: 101585412
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
25
04
2020
revised:
11
05
2020
accepted:
12
05
2020
entrez:
18
9
2020
pubmed:
19
9
2020
medline:
19
9
2020
Statut:
epublish
Résumé
Airway management in patients with hereditary heart disease is an important therapeutic intervention. The purpose of this study was to compare direct laryngoscopy (DL) with video laryngoscopy (VL) in pediatric airways management for congenital heart surgery. This study was designed as a prospective randomized clinical trial. Two consecutive groups of 30 patients undergoing elective noncyanotic congenital heart surgery. The patients were divided into direct laryngoscopy versus video laryngoscopy for intubation of the trachea. The main outcomes were the number of success rate in the first attempt, and the secondary outcomes were the duration of successful intubation and complications, such as desaturation and bradycardia. Intubation procedure time was measured as 51.13 ± 17.88 seconds for the group with direct laryngoscopy and 59.66 ± 45.91 seconds for group with VL that was significant (P = 0.006). In DL group, 22 patients were intubated on the first attempt, 8 patients on the second attempt, and 6 patients on the third attempt, compared to 24, 6, and 2 respectively, in VL group. The differences were significant only in the third attempt between groups (P = 0.033). The important difference established in heart rate (HR) and SpaO VL can produce better visualization for intubation of trachea in congenital heart disease, but this is time-consuming. Indeed, training in the use of the VL should be increased to reduce the time required for performance. Moreover, further studies are recommended to approve these helpful findings.
Sections du résumé
BACKGROUND
BACKGROUND
Airway management in patients with hereditary heart disease is an important therapeutic intervention.
OBJECTIVES
OBJECTIVE
The purpose of this study was to compare direct laryngoscopy (DL) with video laryngoscopy (VL) in pediatric airways management for congenital heart surgery.
METHODS
METHODS
This study was designed as a prospective randomized clinical trial. Two consecutive groups of 30 patients undergoing elective noncyanotic congenital heart surgery. The patients were divided into direct laryngoscopy versus video laryngoscopy for intubation of the trachea. The main outcomes were the number of success rate in the first attempt, and the secondary outcomes were the duration of successful intubation and complications, such as desaturation and bradycardia.
RESULTS
RESULTS
Intubation procedure time was measured as 51.13 ± 17.88 seconds for the group with direct laryngoscopy and 59.66 ± 45.91 seconds for group with VL that was significant (P = 0.006). In DL group, 22 patients were intubated on the first attempt, 8 patients on the second attempt, and 6 patients on the third attempt, compared to 24, 6, and 2 respectively, in VL group. The differences were significant only in the third attempt between groups (P = 0.033). The important difference established in heart rate (HR) and SpaO
CONCLUSIONS
CONCLUSIONS
VL can produce better visualization for intubation of trachea in congenital heart disease, but this is time-consuming. Indeed, training in the use of the VL should be increased to reduce the time required for performance. Moreover, further studies are recommended to approve these helpful findings.
Identifiants
pubmed: 32944555
doi: 10.5812/aapm.99827
pmc: PMC7472645
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e99827Informations de copyright
Copyright © 2020, Author(s).
Déclaration de conflit d'intérêts
Conflict of Interests: The authors report no conflict of interest.
Références
Anesthesiol Res Pract. 2016;2016:4196813
pubmed: 27293429
J Huazhong Univ Sci Technolog Med Sci. 2015 Jun;35(3):432-438
pubmed: 26072085
Acta Anaesthesiol Scand. 2009 Jan;53(1):1-9
pubmed: 19128325
Anesthesiology. 2012 Mar;116(3):622-8
pubmed: 22270505
Paediatr Anaesth. 2014 Oct;24(10):1056-65
pubmed: 24958249
Ann Thorac Surg. 2013 Dec;96(6):2192-7
pubmed: 24070697
Intern Emerg Med. 2014 Feb;9(1):93-8
pubmed: 24002788
Can J Anaesth. 2013 May;60(5):450-7
pubmed: 23435693
Pediatrics. 2016 Mar;137(3):e20152156
pubmed: 26908701
Cochrane Database Syst Rev. 2018 Jun 04;6:CD009975
pubmed: 29862490
Br J Anaesth. 2008 Oct;101(4):531-4
pubmed: 18689807
Ann Emerg Med. 2013 Mar;61(3):271-7
pubmed: 23083969
Acta Anaesthesiol Belg. 2012;63(4):181-6
pubmed: 23610856
Anaesthesia. 2018 Nov;73(11):1337-1344
pubmed: 30112809
Paediatr Anaesth. 2008 Aug;18(8):790-2
pubmed: 18422885