Video-intuboscopic assistance is a useful aid to tracheal intubation in pediatric patients.
OBJECTIVE
To evaluate the efficacy of video-intuboscopic assisted tracheal intubation in a difficult intubation setting.


METHODS
In 50 pediatric patients (mean age 12.8 +/- 3.1 yr, range 6-16 yr) a grade 3 direct laryngoscopic view was simulated. Eight certified registered nurse anesthetists without experience in endoscopic intubation performed tracheal intubation on five or more patients using the video-optical intubation stylet. Time from insertion of the tube into the oral cavity until the tip had passed the vocal cords was recorded. Failed intubation was defined as intubation >60 sec, arterial oxygen saturation <92% or esophageal intubation. Subjective degree of difficulty was asked from the operators using a Likert-scale.


RESULTS
Forty-six of the 50 patients were successfully intubated within 60 sec and without arterial oxygen desaturation. In four patients, video-assisted tracheal intubation failed due to prolonged intubation time. Intubation times ranged from 10-40 sec (median 15 sec). Mean intubation time in the first patient (24.5 +/- 17.3 sec) appeared longer than for the fifth patient (20.8 +/- 10.9 sec), but the difference was not statistically significant (P=0.87). Mean estimated degree of difficulty was 3.9 +/- 2.1. Subjective estimates of difficulty increased with intubation times (P=0.001).


CONCLUSIONS
The video-optical intubation stylet can be considered a valuable aid for tracheal intubation in pediatric patients with a difficult airway.
Weiss
M
M
Department of Anaesthesia, University Children's Hospital, Zurich, Switzerland. markus.weiss@kispi.unizh.ch
Hartmann
K
K
Fischer
J
J
Gerber
A C
AC
D000293:Adolescent; D002648:Child; D005260:Female; D005931:Glottis / Q000033:anatomy & histology; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D009719:Nurse Anesthetists; D014132:Trachea / Q000033:anatomy & histology