Comparison of the TruView infant EVO2 PCD™ and C-MAC video laryngoscopes with direct Macintosh laryngoscopy for routine tracheal intubation in infants with normal airways.
OBJECTIVE
Videolaryngoscopy has mainly been developed to facilitate difficult airway intubation. However, there is a lack of studies demonstrating this method's efficacy in pediatric patients. The aim of the present study was to compare the TruView infant EVO2 and the C-MAC videolaryngoscope with conventional direct Macintosh laryngoscopy in children with a bodyweight ≤10 kg in terms of intubation conditions and the time to intubation.


METHODS
In total, 65 children with a bodyweight ≤10 kg (0-22 months) who had undergone elective surgery requiring endotracheal intubation were retrospectively analyzed. Our database was screened for intubations with the TruView infant EVO2, the C-MAC videolaryngoscope, and conventional direct Macintosh laryngoscopy. The intubation conditions, the time to intubation, and the oxygen saturation before and after intubation were monitored, and demographic data were recorded. Only children with a bodyweight ≤10 kg were included in the analysis.


RESULTS
A total of 23 children were intubated using the C-MAC videolaryngoscope, and 22 children were intubated using the TruView EVO2. Additionally, 20 children were intubated using a standard Macintosh blade. The time required for tracheal intubation was significantly longer using the TruView EVO2 (52 sec vs. 28 sec for C-MAC vs. 26 sec for direct LG). However, no significant difference in oxygen saturation was found after intubation.


CONCLUSIONS
All devices allowed excellent visualization of the vocal cords, but the time to intubation was prolonged when the TruView EVO2 was used. The absence of a decline in oxygen saturation may be due to apneic oxygenation via the TruView scope and may provide a margin of safety. In sum, the use of the TruView by a well-trained anesthetist may be an alternative for difficult airway management in pediatric patients.
Intensive Care Medicine and Pain Therapy, Clinic of Anaesthesiology, Johann Wolfgang Goethe-University Hospital, Frankfurt, Germany, Johann Wolfgang Goethe-University Hospital, Clinic of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany.
Haitham
H
Mutlak
Department of Pediatric Surgery, Johann Wolfgang Goethe-University Hospital, Frankfurt, Germany, Johann Wolfgang Goethe-University Hospital, Department of Pediatric Surgery, Frankfurt, Germany.
Udo
U
Rolle
Intensive Care Medicine and Pain Therapy, Clinic of Anaesthesiology, Johann Wolfgang Goethe-University Hospital, Frankfurt, Germany, Johann Wolfgang Goethe-University Hospital, Clinic of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany.
Willi
W
Rosskopf
Intensive Care Medicine and Pain Therapy, Clinic of Anaesthesiology, Johann Wolfgang Goethe-University Hospital, Frankfurt, Germany, Johann Wolfgang Goethe-University Hospital, Clinic of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany.
Richard
R
Schalk
Intensive Care Medicine and Pain Therapy, Clinic of Anaesthesiology, Johann Wolfgang Goethe-University Hospital, Frankfurt, Germany, Johann Wolfgang Goethe-University Hospital, Clinic of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany.
Kai
K
Zacharowski
Intensive Care Medicine and Pain Therapy, Clinic of Anaesthesiology, Johann Wolfgang Goethe-University Hospital, Frankfurt, Germany, Johann Wolfgang Goethe-University Hospital, Clinic of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany.
Dirk
D
Meininger
Department of Anesthesiology and Intensive Care Medicine, European Medical School Oldenburg-Groningen, Protestant Hospital Oldenburg, Oldenburg, Germany, Protestant Hospital Oldenburg, European Medical School Oldenburg-Groningen, Department of Anesthesiology and Intensive Care Medicine, Oldenburg, Germany.
Christian
C
Byhahn
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D020704:Laryngoscopes / Q000592:standards*; D007828:Laryngoscopy / Q000295:instrumentation* / Q000379:methods; D008297:Male; D010100:Oxygen / Q000097:blood; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D020535:Video-Assisted Surgery / Q000295:instrumentation* / Q000379:methods
D010100:Oxygen