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. Jain & 23 others S. 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

13 Citations (Scopus)

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

Fingerprint

Laryngoscopy
Intubation
Registries
Pediatrics
Equipment and Supplies
Odds Ratio
Confidence Intervals
Wounds and Injuries

Keywords

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

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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. ; Jain, R. ; Khalil, S. ; Polaner, D. ; Zieg, J. ; Szolnoki, J. ; Sathyamoorthy, M. ; Taicher, B. ; Bhattacharya, S. ; Raman, V. ; Bhalla, T. ; Stricker, P. ; Lockman, J. ; Galvez, J. ; Rehman, Mdm ; Nishisaki, A. ; Von Ungern-Sternberg, B. ; Sommerfield, D. ; Soneru, C. ; Chiao, F. ; Richtsfeld, M. ; Belani, K. ; Sarmiento, L. ; Mireles, S. ; Rosas, G. B. / The efficacy of GlideScope ® videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate : An analysis from the paediatric difficult intubation registry. In: British journal of anaesthesia. 2017 ; Vol. 119, No. 5. pp. 984-992.
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abstract = "Background We analysed data from the Paediatric Difficult Intubation Registry examining the use of direct laryngoscopy and GlideScope {\circledR} 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.",
keywords = "airway management, children, difficult intubation, intratracheal intubation, videolaryngoscopy",
author = "R. Park and Peyton, {J. M.} and Fiadjoe, {J. E.} and Hunyady, {A. I.} and T. Kimball and D. Zurakowski and Kovatsis, {P. G.} and A. Bosenberg and P. Hopkins and C. Glover and O. Olutoye and P. Szmuk and P. Olomu and N. Jagannathan and N. Burjek and S. Watkins and P. Reynolds and B. Haydar and M. Matuszczak and R. Jain and S. Khalil and D. Polaner and J. Zieg and J. Szolnoki and M. Sathyamoorthy and B. Taicher and S. Bhattacharya and V. Raman and T. Bhalla and P. Stricker and J. Lockman and J. Galvez and Mdm Rehman and A. Nishisaki and {Von Ungern-Sternberg}, B. and D. Sommerfield and C. Soneru and F. Chiao and M. Richtsfeld and K. Belani and L. Sarmiento and S. Mireles and Rosas, {G. B.}",
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Park, R, Peyton, JM, Fiadjoe, JE, Hunyady, AI, Kimball, T, Zurakowski, D, Kovatsis, PG, Bosenberg, A, Hopkins, P, Glover, C, Olutoye, O, Szmuk, P, Olomu, P, Jagannathan, N, Burjek, N, Watkins, S, Reynolds, P, Haydar, B, Matuszczak, M, Jain, R, Khalil, S, Polaner, D, Zieg, J, Szolnoki, J, Sathyamoorthy, M, Taicher, B, Bhattacharya, S, Raman, V, Bhalla, T, Stricker, P, Lockman, J, Galvez, J, Rehman, M, Nishisaki, A, Von Ungern-Sternberg, B, Sommerfield, D, Soneru, C, Chiao, F, Richtsfeld, M, Belani, K, Sarmiento, L, Mireles, S & Rosas, GB 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, vol. 119, no. 5, pp. 984-992. https://doi.org/10.1093/bja/aex344

The efficacy of GlideScope ® videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate : An analysis from the paediatric difficult intubation registry. / 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.; Jain, R.; Khalil, S.; Polaner, D.; Zieg, J.; Szolnoki, J.; Sathyamoorthy, M.; Taicher, B.; Bhattacharya, S.; Raman, V.; Bhalla, T.; Stricker, P.; Lockman, J.; Galvez, J.; Rehman, Mdm; Nishisaki, A.; Von Ungern-Sternberg, B.; Sommerfield, D.; Soneru, C.; Chiao, F.; Richtsfeld, M.; Belani, K.; Sarmiento, L.; Mireles, S.; Rosas, G. B.

In: British journal of anaesthesia, Vol. 119, No. 5, 01.11.2017, p. 984-992.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The efficacy of GlideScope ® videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate

T2 - An analysis from the paediatric difficult intubation registry

AU - Park, R.

AU - Peyton, J. M.

AU - Fiadjoe, J. E.

AU - Hunyady, A. I.

AU - Kimball, T.

AU - Zurakowski, D.

AU - Kovatsis, P. G.

AU - Bosenberg, A.

AU - Hopkins, P.

AU - Glover, C.

AU - Olutoye, O.

AU - Szmuk, P.

AU - Olomu, P.

AU - Jagannathan, N.

AU - Burjek, N.

AU - Watkins, S.

AU - Reynolds, P.

AU - Haydar, B.

AU - Matuszczak, M.

AU - Jain, R.

AU - Khalil, S.

AU - Polaner, D.

AU - Zieg, J.

AU - Szolnoki, J.

AU - Sathyamoorthy, M.

AU - Taicher, B.

AU - Bhattacharya, S.

AU - Raman, V.

AU - Bhalla, T.

AU - Stricker, P.

AU - Lockman, J.

AU - Galvez, J.

AU - Rehman, Mdm

AU - Nishisaki, A.

AU - Von Ungern-Sternberg, B.

AU - Sommerfield, D.

AU - Soneru, C.

AU - Chiao, F.

AU - Richtsfeld, M.

AU - Belani, K.

AU - Sarmiento, L.

AU - Mireles, S.

AU - Rosas, G. B.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - 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.

AB - 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.

KW - airway management

KW - children

KW - difficult intubation

KW - intratracheal intubation

KW - videolaryngoscopy

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U2 - 10.1093/bja/aex344

DO - 10.1093/bja/aex344

M3 - Article

VL - 119

SP - 984

EP - 992

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 5

ER -