Airway Management in Neonates and Young Infants: Changes in Clinical Outcomes With Adoption of Routine Video Laryngoscopy in a Single Center Retrospective Cohort
Authors' conclusion
We found clinically important improvements in first attempt tracheal intubation over time.
Study context
- Population
- Neonates and infants < 2 months of age with tracheal intubation for noncardiac procedures, August 2012 to May 2024
- Participants
- 3,724 neonates
- Exposure
- Standard blade video laryngoscopy vs direct laryngoscopy
- SVLn = 1,607
- Direct laryngoscopy (DL)n = 2,117reference
- Outcome
- First attempt success and incidence of difficult intubation
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
First attempt tracheal intubation success, overall
80.4%
2994/3724
Difficult intubation, overall
5.0%
186/3724
Observational data: associations, not effects.
Further findings
| Outcome | SVL | DL | Estimate | P value | |
|---|---|---|---|---|---|
| First attempt success by laryngoscope | 85.9% | 76.2% | aOR for first attempt success 1.77 (95% CI 1.48–2.12) | P < 0.001 | |
| Difficult intubation by laryngoscope | 3.1% | 6.5% | aOR for difficult intubation 0.47 (95% CI 0.33–0.66) | P < 0.001 | |
| 0.20.5125Ratio (log scale) |
Hypoxemia at induction
- Hypoxemia at induction
- 5.5% (205/3724)
- Each additional intubation attempt strongly associated with hypoxemia at induction
Temporal trend
- First attempt success increased over time, paralleling increased SVL use
Safety
- Hypoxemia at induction
- 5.5% (205/3724)
- Airway-related cardiac arrest
- 0.2% (6/3724)
- Each additional intubation attempt strongly associated with hypoxemia at induction
Original publication
Airway Management in Neonates and Young Infants: Changes in Clinical Outcomes With Adoption of Routine Video Laryngoscopy in a Single Center Retrospective Cohort. Paediatr Anaesth. Published 4 May 2026. doi:10.
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