A comparison of videolaryngoscopy using standard blades or non-standard blades in children in the Paediatric Difficult Intubation Registry.
airway
difficult intubation
infant
neonate
paediatric
videolaryngoscopy
Journal
British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
02
03
2020
revised:
15
07
2020
accepted:
04
08
2020
pubmed:
21
9
2020
medline:
29
1
2021
entrez:
20
9
2020
Statut:
ppublish
Résumé
The design of a videolaryngoscope blade may affect its efficacy. We classified videolaryngoscope blades as standard and non-standard shapes to compare their efficacy performing tracheal intubation in children enrolled in the Paediatric Difficult Intubation Registry. Cases entered in the Registry from March 2017 to January 2020 were analysed. We compared the success rates of initial and eventual tracheal intubation, complications, and technical difficulties between the two groups and by weight stratification. Videolaryngoscopy was used in 1313 patients. Standard and non-standard blades were used in 529 and 740 patients, respectively. Both types were used in 44 patients. In children weighing <5 kg, standard blades had significantly greater success than non-standard blades at initial (51% vs 26%, P=0.002) and eventual (81% vs 58%, P=0.002) attempts at tracheal intubation. In multivariable logistic regression analysis, standard blades had 3-fold greater odds of success at initial tracheal intubations compared with non-standard blades (adjusted odds ratio 3.0, 95% confidence interval): 1.32-6.86, P=0.0009). Standard blades had 2.6-fold greater odds of success at eventual tracheal intubation compared with non-standard blades in children weighing <5 kg (adjusted odds ratio 2.6, 95% confidence interval: 1.08-6.25, P=0.033). There was no significant difference found in children weighing ≥5 kg. In infants weighing <5 kg, videolaryngoscopy with standard blades was associated with a significantly greater success rate than videolaryngoscopy with non-standard blades. Videolaryngoscopy with a standard blade is a sensible choice for tracheal intubation in children who weigh <5 kg.
Sections du résumé
BACKGROUND
BACKGROUND
The design of a videolaryngoscope blade may affect its efficacy. We classified videolaryngoscope blades as standard and non-standard shapes to compare their efficacy performing tracheal intubation in children enrolled in the Paediatric Difficult Intubation Registry.
METHODS
METHODS
Cases entered in the Registry from March 2017 to January 2020 were analysed. We compared the success rates of initial and eventual tracheal intubation, complications, and technical difficulties between the two groups and by weight stratification.
RESULTS
RESULTS
Videolaryngoscopy was used in 1313 patients. Standard and non-standard blades were used in 529 and 740 patients, respectively. Both types were used in 44 patients. In children weighing <5 kg, standard blades had significantly greater success than non-standard blades at initial (51% vs 26%, P=0.002) and eventual (81% vs 58%, P=0.002) attempts at tracheal intubation. In multivariable logistic regression analysis, standard blades had 3-fold greater odds of success at initial tracheal intubations compared with non-standard blades (adjusted odds ratio 3.0, 95% confidence interval): 1.32-6.86, P=0.0009). Standard blades had 2.6-fold greater odds of success at eventual tracheal intubation compared with non-standard blades in children weighing <5 kg (adjusted odds ratio 2.6, 95% confidence interval: 1.08-6.25, P=0.033). There was no significant difference found in children weighing ≥5 kg.
CONCLUSIONS
CONCLUSIONS
In infants weighing <5 kg, videolaryngoscopy with standard blades was associated with a significantly greater success rate than videolaryngoscopy with non-standard blades. Videolaryngoscopy with a standard blade is a sensible choice for tracheal intubation in children who weigh <5 kg.
Identifiants
pubmed: 32950248
pii: S0007-0912(20)30656-5
doi: 10.1016/j.bja.2020.08.010
pii:
doi:
Types de publication
Comparative Study
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
331-339Investigateurs
David Sommerfield
(D)
Chris Holmes
(C)
Niroop Ravula
(N)
Christine Jette
(C)
Sam Mireles
(S)
Clyde Matava
(C)
Simon Whyte
(S)
Eduardo Vega
(E)
Lei Yang
(L)
Piedad Echeverry-Marin
(P)
Carolina Perez-Pradilla
(C)
Elizabeth Starker
(E)
Jennifer Zieg
(J)
Judit Szolnoki
(J)
Angela Lee
(A)
Eugenie Heitmiller
(E)
Mohamed Rehman
(M)
Lillian Zamora
(L)
Allison Fernandez
(A)
Jonathan Meserve
(J)
Solmaletha Bhattacharya
(S)
Paul Reynolds
(P)
Ian Lewis
(I)
Bishr Haydar
(B)
Megan Therrian
(M)
Linare Sarmiento
(L)
Martina Richtsfeld
(M)
Kumar Belani
(K)
Sara Robertson
(S)
Kumar Sathyamoorthy
(K)
Charles Schrock
(C)
Jurgen de Graaff
(J)
Codruta Soneru
(C)
Neeta Singh
(N)
Brad Taicher
(B)
Pilar Castro
(P)
N R Riveros Perez
(NR)
Paul Stricker
(P)
Justin L Lockman
(JL)
Jorge Galvez
(J)
Rebecca Isserman
(R)
Brian Struyk
(B)
Christopher Ward
(C)
Grace Hsu
(G)
Akira Nishisaki
(A)
Ramesh Kodavatiganti
(R)
Luis S Ramos
(LS)
Eric Scheu
(E)
Benjamin Bruins
(B)
Tally Goldfarb
(T)
Peter Szmuk
(P)
Ranu Jain
(R)
Maria Matuszczak
(M)
David Polaner
(D)
Agnes Hunyady
(A)
Adrian Bosenberg
(A)
See Tham
(S)
Daniel Low
(D)
Guelay B Rosas
(GB)
Lisa K Lee
(LK)
Ihab Iyah
(I)
Nicholas Dalesio
(N)
Rob Greenberg
(R)
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.