title: A comparison of the STORZ video laryngoscope and standard direct laryngoscopy for intubation in the Pediatric airway--a randomized clinical trial.
abstract: BACKGROUND
  Direct laryngoscopy can be challenging in infants and neonates. Even with an optimal line of sight to the glottic opening, the viewing angle has been measured at 15 degrees . The STORZ DCI video laryngoscope (Karl Storz, Tuttlingen, Germany) incorporates a fiberoptic camera in the light source of a standard laryngoscope of variable sizes. The image is displayed on a screen with a viewing angle of 80 degrees . We studied the effectiveness of the STORZ DCI as an airway tool compared to standard direct laryngoscopy in children with normal airway.
  
  
  METHODS
  In this prospective, randomized study, 56 children (ages 4 years or younger) undergoing elective surgery with the need for endotracheal intubation were divided into two groups: children who underwent standard direct laryngoscopy using a Miller 1 or Macintosh 2 blade (DL) and children who underwent video laryngoscopy using the STORZ DCI video laryngoscope with a Miller 1 blade (VL). Time to best view (TTBV), time to intubate (TTI), Cormack-Lehane (CL), and percentage of glottis opening seen (POGO) score were recorded.
  
  
  RESULTS
  TTBV in DL was 5.5 (4-8) s and 7 (4.2-9) s in VL. TTI in DL was 21 (17-29) s and in VL 27 (22-37) s (P = 0.006). The view as assessed by POGO score was 97.5% (60-100%) in DL and 100% (100-100%) in the VL (P = 0.003). Data are presented as median and interquartile range and analyzed using t-test.
  
  
  CONCLUSIONS
  This study demonstrates that the STORZ DCI video laryngoscope provides an improved view to the glottis in children with normal airway anatomy, but requires a longer time for intubation.
authors.affiliation: Department of Pediatric Anesthesia and Pediatric Critical Care, IWK Health Centre, Halifax, NS, Canada. arnim.vlatten@iwk.nshealth.ca
authors.forename: Arnim
authors.initials: A
authors.lastname: Vlatten
authors.forename: Sylvie
authors.initials: S
authors.lastname: Aucoin
authors.forename: Sharon
authors.initials: S
authors.lastname: Litz
authors.forename: Brian
authors.initials: B
authors.lastname: Macmanus
authors.forename: Chris
authors.initials: C
authors.lastname: Soder
mesh_terms: D000769:Anesthesia, Inhalation / Q000295:instrumentation* / Q000379:methods; D002675:Child, Preschool; D017558:Elective Surgical Procedures; D004867:Equipment Design; D005260:Female; D005931:Glottis / Q000033:anatomy & histology; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome