title: Comparison of the Miller Laryngoscope and Videolaryngoscope for Tracheal Intubation by Novice Doctors during Neonatal Cardiopulmonary Resuscitation: A Randomized Crossover Simulation Trial.
abstract: OBJECTIVE
  Recent guidelines for neonatal cardiopulmonary resuscitation emphasize the importance of adequate ventilation. In cases of failed resuscitation with positive pressure ventilation, tracheal intubation and chest compressions are recommended. The present study compared the utility of the Miller laryngoscope (Mil) and the videolaryngoscope Pentax-AWS Airway Scope (AWS; Hoya, Tokyo, Japan) with an infant or neonatal-sized Intlock (AWS-N; Pentax) during chest compressions on a neonatal manikin.
  
  
  METHODS
  A total of 23 novice doctors performed tracheal intubation on a neonatal manikin using the Mil and AWS-N, with or without chest compressions.
  
  
  RESULTS
  In the Mil trials, all participants secured the airway without chest compressions, but nine failed with compressions (p < 0.001). In AWS-N trials, all participants succeeded regardless of whether chest compressions were performed or not. Intubation time was significantly longer with chest compressions with the Mil (p < 0.001), but not with the AWS-N. Laryngoscopy difficulty, as assessed by a visual analog scale (VAS), increased significantly with chest compressions with the Mil, but not with the AWS-N, while the VAS for tube passage through the glottis increased with compressions with the Mil, but not with the AWS-N.
  
  
  CONCLUSIONS
  The AWS-N is an effective device for endotracheal intubation during chest compressions in neonatal simulations performed by novice doctors.
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Osaka, Japan.
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Komasawa
authors.affiliation: Department of Anesthesiology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ueki
authors.affiliation: Department of Anesthesiology, Social Insurance Kinan Hospital, Tanabe, Japan.
authors.forename: Yoshiroh
authors.initials: Y
authors.lastname: Kaminoh
authors.affiliation: Division of Intensive Care Unit, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Nishi
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D018592:Cross-Over Studies; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D020704:Laryngoscopes / Q000706:statistics & numerical data*; D007828:Laryngoscopy / Q000295:instrumentation*; D008348:Manikins; D010820:Physicians