Comparative evaluation of Airtraq™ and GlideScope® videolaryngoscopes for difficult pediatric intubation in a Pierre Robin manikin

Neel Desai; Mae Johnson; Kat Priddis; Samiran Ray; Linda Chigaru

doi:10.1007/s00431-019-03396-7

Comparative evaluation of Airtraq™ and GlideScope® videolaryngoscopes for difficult pediatric intubation in a Pierre Robin manikin

Eur J Pediatr. 2019 Jul;178(7):1105-1111. doi: 10.1007/s00431-019-03396-7. Epub 2019 May 23.

Authors

Neel Desai¹, Mae Johnson^{2

3}, Kat Priddis², Samiran Ray^{2

4}, Linda Chigaru^{2

3}

Affiliations

¹ Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, UK. neel_d83@hotmail.com.
² Children's Acute Transport Service, Ormond House, 26-27 Boswell Street, London, UK.
³ Department of Anaesthetics, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK.
⁴ Respiratory, Critical Care and Anaesthesia Section, University College London Great Ormond Street Institute of Child Health, 30 Guildford Street, London, UK.

PMID: 31119438
DOI: 10.1007/s00431-019-03396-7

Abstract

Airway management in children is associated with anatomical and physiological challenges compared with adults. Pierre Robin sequence (PRS) is a condition characterized by micrognathia, glossoptosis, and cleft palate and related to a difficult airway. Both the Airtraq™ and GlideScope® have never been previously directly compared in PRS. Our aim was to evaluate the performance of these two airway devices in a PRS manikin for ethical and practical reasons. Between April and July 2017, 26, pediatric intensive care clinical fellows or trainees from a tertiary pediatric center were recruited to participate. In this prospective and randomized crossover trial, all participants first set up the Airtraq™ and the GlideScope® and then used these videolaryngoscopes to intubate an AirSim® PRS manikin. Our primary outcome measure was the duration of the successful intubation attempt. Duration of the successful intubation attempt was 18.1 (14.2-34.9 [10.2-51.3]) s for the Airtraq™ compared to 31.1 (18.7-55.6 [6.2-119]) s for the GlideScope® (p = 0.045). Setup time was 50.0 ± 6.9 s for the Airtraq™ and 27.8 ± 8.6 s for the GlideScope® (p < 0.001).Conclusion: Even though setup time was longer, the characteristics of intubation performance were superior with the Airtraq™ relative to the GlideScope® in an AirSim® PRS manikin. What is Known: • Several case reports have described the successful use of Airtraq™ to intubate children with Pierre Robin sequence. • The GlideScope® has demonstrated similar rates of first-attempt successful intubation to flexible fiberoptic bronchoscopy in a Pierre Robin sequence manikin. What is New: • In the hands of pediatric non-airway specialists, the characteristics of intubation performance, including the duration of the successful intubation attempt, are superior with the Airtraq™ compared with the GlideScope® in a Pierre Robin sequence manikin. • Setup time for the Airtraq™ is, however, longer relative to that for the GlideScope®.

Keywords: Intubation; Laryngoscopy; Manikins; Pediatrics; Pierre Robin syndrome.

Publication types

Comparative Study
Randomized Controlled Trial

MeSH terms

Airway Obstruction / therapy*
Child
Cross-Over Studies
Humans
Intubation, Intratracheal / instrumentation*
Laryngoscopes*
Laryngoscopy / instrumentation*
Manikins
Time Factors
Video-Assisted Surgery / methods*