title: A prospective randomized equivalence trial of the GlideScope Cobalt® video laryngoscope to traditional direct laryngoscopy in neonates and infants.
abstract: BACKGROUND
  Intubation in children is increasingly performed using video laryngoscopes. Many pediatric studies examine novice laryngoscopists or describe single patient experiences. This prospective randomized nonblinded equivalence trial compares intubation time for the GlideScope Cobalt® video laryngoscope (GCV, Verathon Medical, Bothell, WA) with direct laryngoscopy with a Miller blade (DL, Heine, Dover, NH) in anatomically normal neonates and infants. The primary hypothesis was that intubation times with GCV would be noninferior to DL.
  
  
  METHODS
  Sixty subjects presenting for elective surgery were randomly assigned to intubation using GCV or DL. Intubation time, time to best view, percentage of glottic opening score, and intubation success were documented. We defined an intubation time difference of less than 10 s as clinically insignificant.
  
  
  RESULTS
  There was no difference in intubation time between the groups (GCV median = 22.6 s; DL median = 21.4 s; P = 0.24). The 95% one-sided CI for mean difference between the groups was less than 8.3 s. GCV yielded faster time to best view (median = 8.1 s; DL 9.9 s; P = 0.03). Endotracheal tube passage time was longer for GCV (median = 14.3 s; DL 8.5 s; P = 0.007). The percentage of glottic opening score was improved with GCV (median 100; DL 80; P < 0.0001).
  
  
  CONCLUSIONS
  Similar intubation times and success rates were achieved in anatomically normal neonates and infants with the GCV as with DL. The GCV yielded faster time to best view and better views but longer tube passage times than DL.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Pennsylvania 19104 USA. fiadjoej@email.chop.edu
authors.forename: John E
authors.initials: JE
authors.lastname: Fiadjoe
authors.forename: Harshad
authors.initials: H
authors.lastname: Gurnaney
authors.forename: Nicholas
authors.initials: N
authors.lastname: Dalesio
authors.forename: Emily
authors.initials: E
authors.lastname: Sussman
authors.forename: Huaqing
authors.initials: H
authors.lastname: Zhao
authors.forename: Xuemei
authors.initials: X
authors.lastname: Zhang
authors.forename: Paul A
authors.initials: PA
authors.lastname: Stricker
mesh_terms: D000367:Age Factors; D003035:Cobalt; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020704:Laryngoscopes / Q000592:standards; D007828:Laryngoscopy / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D008297:Male; D011446:Prospective Studies; D013810:Therapeutic Equivalency; D014741:Video Recording / Q000295:instrumentation / Q000379:methods* / Q000592:standards
chemical_list: D003035:Cobalt