Airway management in pediatric patients using the Glidescope Cobalt®: a feasibility study.
BACKGROUND
Video laryngoscopes are claimed to improve airway management. Several studies showed an equal or better glottic view using the Glidescope® compared with direct laryngoscopy in adults and in paediatric patients. Many case reports also described successful intubation in patients with a difficult airway. The Glidescope Cobalt® is a modified Glidescope® with a disposable sheath. Data on clinical application in paediatric patients is insufficient.


METHODS
Twenty-four pediatric patients with a mean age of 27 months [range, 1-142] undergoing general anesthesia were included into this feasibility study. Cormack and Lehane grade was evaluated using a Macintosh blade. Tracheal intubation was performed using the Glidescope Cobalt®. Number of attempts, time to intubation, Cormack and Lehane (C&L) grade and a subjective score were noted for both a resident and an attending anesthesiologist.


RESULTS
With the Glidescope Cobalt® the C&L grade improved in all patients with grade 2 or 3 to 1 and deteriorated in one case from C&L grade 1 to 2. The C&L grade remained unchanged in 15 patients (62.5%). C&L grades between resident and attending anesthesiologist were equal. Tracheal intubation was successful in 92% with a stylet-armed tube and in 8% using an unarmed tube with a Magill forceps, respectively. Time to intubation was median 50.5 [range, 22-93] seconds.


CONCLUSIONS
The Glidescope Cobalt® presented suitable for use in children. C&L grade was significantly improved in all patients with a C&L grade of 2 or 3. Especially for educational purposes in pediatric anesthesia it provides a good view for all participants.
Department of Anesthesiology and Intensive Care Medicine, University-Hospital Schleswig-Holstein, Campus Kiel, Germany. Christoph.ilies@uksh.de
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Ilies
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Fudickar
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Thee
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Dütschke
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Hanss
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Bein
D058109:Airway Management / Q000295:instrumentation* / Q000379:methods; D000769:Anesthesia, Inhalation; D000776:Anesthesiology / Q000193:education; D000886:Anthropometry; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005931:Glottis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007396:Internship and Residency; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D011229:Preanesthetic Medication; D013514:Surgical Procedures, Operative; D014741:Video Recording / Q000295:instrumentation* / Q000379:methods