title: Pediatric airway management: comparing the Berci-Kaplan Video Laryngoscope with direct laryngoscopy.
abstract: OBJECTIVE
  To assess the utility of the Berci-Kaplan Video Laryngoscope (VL) in pediatric anesthesia.
  
  
  BACKGROUND
  The VL is designed to improve visualization of the glottis during tracheal intubation of normal and difficult airways in adults. This study was designed to assess the visual quality and the ease of tracheal intubation in children using the VL when compared with direct laryngoscopy (DL).
  
  
  METHODS
  Sixty children, aged 2-16 years requiring tracheal intubation, were enrolled in this prospective, randomized clinical trial. Following induction of anesthesia and muscle paralysis, the first laryngoscopy method, using either a DL or the VL, was performed by one anesthetist, and the laryngoscopic view was graded according to the Cormack-Lehane scale. Laryngoscopy and grading of the view in the second method were then performed by a second anesthetist. Tracheal intubation was completed following the second laryngoscopy, and time to intubation was recorded.
  
  
  RESULTS
  The average age and weight were 8.9 +/- 3.6 years and 34.9 +/- 16.0 kg respectively. Videolaryngoscopy improved 8/11 grade 2 views to grade 1 (P = 0.02), and one grade 3 to a grade 2. Three grade 2 views remained unchanged from DL to VL. 4/30 VL intubations required two attempts, and 1/30 failed after two attempts, but was easily intubated with DL. Median time (range) was 16.0 s (14.0-20.0 s) and 22.5 s (17.8-35.0 s) for DL and VL respectively (P < 0.001).
  
  
  CONCLUSIONS
  Videolaryngoscopy provides better views than DL at the expense of time to intubate. Although the time taken to intubate is increased with the VL, it is clinically acceptable.
authors: Department of Paediatric Anaesthesia, Royal Aberdeen Children's Hospital, Aberdeen, UK.
authors: David
authors: D
authors: Macnair
authors: Dan
authors: D
authors: Baraclough
authors: Graham
authors: G
authors: Wilson
authors: Mark
authors: M
authors: Bloch
authors: Thomas
authors: T
authors: Engelhardt
mesh_terms: D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome