Pediatric anesthesia & critical care
Universal paediatric videolaryngoscopy and glottic view grading: a prospective observational study
Authors' conclusion
Universal, first-choice videolaryngoscopy reduced substantially the incidence of restricted glottic views. The Cormack and Lehane classification was not a useful tool for grading videolaryngoscopic tracheal intubation in children.
Study context
- Population
- Anaesthetised children undergoing elective tracheal intubation for surgical procedures904 tracheal intubations
- Participants
- 809 children
- Exposure
- Videolaryngoscopic vs direct glottic view during laryngoscopy
- Outcome
- Incidence of restricted glottic views
Methodological detailsuniversal videolaryngoscopy implementation programme, 16-month period
- Universal videolaryngoscopy implementation programme
- 16-month period
Main finding
As reported in the abstract
Restricted glottic view
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Videolaryngoscopic view | Direct view | P value |
|---|---|---|---|
| Cormack and Lehane classification discriminating easy vs difficult videolaryngoscopic intubationDiscriminated poorly | P = 0.005 | ||
| Mean AUC | 0.68 (95%CI 0.59-0.78) | 0.80 (95%CI 0.73-0.87) |
Improved glottic view with videolaryngoscopy
- Vocal cords only just visible by direct view
- 57/69 (83%)
- Vocal cords not visible by direct view
- 44/48 (92%)
Intubation success
- First attempt success
- 607 (67%)
- Overall success
- 903 (> 99%)
- Difficult videolaryngoscopic intubation
- 47 (5%)
Safety
- Airway-related adverse events
- 42 (5%)
Original publication
Universal paediatric videolaryngoscopy and glottic view grading: a prospective observational study. Anaesthesia. Published 11 July 2024. doi:10.
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