Pediatric anesthesia & critical care
Efficacy of a hybrid technique of simultaneous videolaryngoscopy with flexible bronchoscopy in children with difficult direct laryngoscopy in the Pediatric Difficult Intubation Registry
Main finding · First attempt successResult — go to the resultOR for first attempt success 1.4 95% CI 0.9–2.1Authors' conclusion
While technically challenging, the hybrid technique has success rates similar to other advanced airway techniques, few complications and may be considered an alternative technique when developing an airway plan for paediatric patients whose tracheas are difficult to intubate under general anaesthesia.
Study context
- Population
- Children with difficult direct laryngoscopy under GA, international Pediatric Difficult Intubation Registry, 2017–2021propensity score-matched 4:1
- Participants
- 140 vs 560
- Exposure
- Hybrid vs flexible bronchoscope
- Hybridn = 140
- Flexible bronchoscopen = 560reference
- Outcome
- First attempt success
Methodological detailspropensity score-matched 4:1, international registry
- Propensity score-matched 4:1
- International registry
Main finding
As reported in the abstract
OR for first attempt success
1.4
95% CI 0.9–2.1
P = 0.1
Events by group
Hybrid vs Flexible bronchoscope
OR for first attempt success 1.4 (95% CI 0.9–2.1); P = 0.1
Observational data: associations, not effects.
Further findings
Eventual success
1.1 (CI 0.6–2.1) · P = 0.8
Used as rescue technique after failure of another technique
2.1 (CI 1.4–3.2) · P < 0.001
Safety
Complications (per attempt)
P = 0.3
- Complications (per attempt): 28 complications in 182 attempts vs 102 in 800 attempts
Original publication
Efficacy of a hybrid technique of simultaneous videolaryngoscopy with flexible bronchoscopy in children with difficult direct laryngoscopy in the Pediatric Difficult Intubation Registry. Anaesthesia. Published 15 June 2023. doi:10.
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