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Wieczorek P, Pruc M, Krajsman MJ, Wieczorek W, Cander B, Szarpak L, Navolokina A, Matuszewski M, Zyla M, Bragazzi NL, Smereka J. A randomized crossover comparison of the bébé VieScope and direct laryngoscope for pediatric airway management by nurses in medical simulation settings. Expert Rev Med Devices 2023; 20:943-950. [PMID: 37668350 DOI: 10.1080/17434440.2023.2253142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Airway management in life-threatening emergencies is essential for children, and endotracheal intubation is the gold standard. It protects against regurgitation and enables mechanical ventilation. New types of airway management equipment are being developed and implemented to meet the needs of medical personnel. RESEARCH DESIGN AND METHODS This prospective, randomized, cross-over simulation trial evaluated the success of endotracheal intubation in three scenarios: normal airway (scenario-A), tongue edema (scenario-B), and continuous chest compression (scenario-C), using the bébé Vie Scope™ laryngoscope (VieScope) and the Macintosh blade laryngoscope (MAC) as a comparative tool performed by nurses with limited tracheal intubation experience. RESULTS The results of the study showed that in scenario-A, there were no significant differences in the first attempt success rate or endotracheal intubation time between VieScope and MAC. However, VieScope was associated with better visualization of the glottis. In scenarios B and C, VieScope was significantly more effective than MAC in terms of first-pass success rate, time to intubate, Cormack-Lehane grade, POGO score, and ease of endotracheal intubation. CONCLUSIONS Bébé VieScope may be useful for endotracheal intubation in pediatric patients, particularly in cases of tongue edema and ongoing chest compression, providing a higher first-pass success rate than conventional laryngoscopes.
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Affiliation(s)
- Pawel Wieczorek
- Pediatric Intensive Care Unit (PICU), John Paul II Upper Silesian Health Centre in Katowice, Katowice, Poland
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Maciej J Krajsman
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Wieczorek
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Basar Cander
- Department of Emergency Medicine, Bezmialem Vakif University, Fatih/Istanbul, Turkey
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, USA
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Alla Navolokina
- European School of Medicine, International European University, Kyiv, Ukraine
| | - Michal Matuszewski
- Department of Anaesthesiology and Intensive Therapy The Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
| | - Michal Zyla
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Nicola L Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK
| | - Jacek Smereka
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
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Sawa T, Kainuma A, Akiyama K, Kinoshita M, Shibasaki M. Difficult Airway Management in Neonates and Infants: Knowledge of Devices and a Device-Oriented Strategy. Front Pediatr 2021; 9:654291. [PMID: 34026688 PMCID: PMC8138561 DOI: 10.3389/fped.2021.654291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Difficult airway management (DAM) in neonates and infants requires anesthesiologists and critical care clinicians to respond rapidly with appropriate evaluation of specific situations. Therefore, organizing information regarding DAM devices and device-oriented guidance for neonate and infant DAM treatment will help practitioners select the safest and most effective strategy. Based on DAM device information and reported literature, there are three modern options for DAM in neonates and infants that can be selected according to the anatomical difficulty and device-oriented strategy: (1) video laryngoscope (VLS), (2) supraglottic airway device (SAD), and (3) flexible fiberoptic scope (FOS). Some VLSs are equipped with small blades for infants. Advanced SADs have small sizes for infants, and some effectively function as conduits for endotracheal intubation. The smallest FOS has an outer diameter of 2.2 mm and enables intubation with endotracheal tubes with an inner diameter of 3.0 mm. DAM in neonates and infants can be improved by effectively selecting the appropriate device combination and ensuring that available providers have the necessary skills.
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Affiliation(s)
- Teiji Sawa
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Kainuma
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Akiyama
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Anesthesia, Yodogawa Christian Hospital, Osaka, Japan
| | - Mao Kinoshita
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masayuki Shibasaki
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Szarpak L. Laryngoscopes for difficult airway scenarios: a comparison of the available devices. Expert Rev Med Devices 2018; 15:631-643. [PMID: 30099914 DOI: 10.1080/17434440.2018.1511423] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION According to the American Society of Anesthesiologists, the incidence of difficult intubation in the operating room is 1.2-3.8%; however, in emergency conditions, this rate is higher and reaches even 5.3%. Successful emergency airway management is an essential component of the modern practice of medicine. AREAS COVERED The aim of the study is to review the literature regarding different devices used to perform endotracheal intubation (Macintosh, Miller, and McCoy laryngoscopes; ETView, GlideScope, TruView, Airtraq, McGrath MAC, Pentax AWS, Trachlight, Shikani, and Bullard) and discuss their clinical and experimental role in difficult airway management. EXPERT COMMENTARY Owing to the development of medical technology, there are an increasing number of videolaryngoscopes and other devices facilitating endotracheal intubation in difficult airway scenarios, including cardiopulmonary resuscitation, cervical spine injury, or face-to-face intubation. Each of these devices may bring benefits in the form of increasing the intubation effectiveness, as well as shortening the procedure, provided that the person performing intubation is familiar with the use of the device.
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Affiliation(s)
- Lukasz Szarpak
- a Faculty of Medicine , Lazarski University , Warsaw , Poland
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