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Comparison of the airtraq laryngoscope to the direct laryngoscopy in the pediatric airway

Article type: Other

Authors: Vlatten, A.; ; | Fielding, A. | Bernard, A. | Litz, S.; | MacManus, B.; | Soder, C.;

Affiliations: Departments of Pediatric Anesthesia and Pediatric Critical Care, IWK Health Centre, Halifax, NS, Canada | Department of Anesthesia, Dalhousie University, Halifax, NS, Canada

Note: [] Corresponding author: Arnim Vlatten, Department of Pediatric Anesthesia and Department of Pediatric Critical Care, IWK Health Centre, 5850/5980 University Avenue, PO Box 9700 Halifax, B3K 6R8, Nova Scotia, Canada. Tel.: +1 902 470 8251; Fax: +1 902 470 7911; E-mail: arnim.vlatten@iwk.nshealth.ca.

Keywords: Airway, pediatric, video laryngoscope

DOI: 10.3233/PIC-2012-013

Journal: Journal of Pediatric Intensive Care, vol. 1, no. 2, pp. 71-76, 2012

Received 14 October 2010
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Revision received 2 December 2010
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Accepted 3 January 2011
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Published: 2012
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Abstract

Direct laryngoscopy (DL) is the most commonly used technique for tracheal intubation, but there is ongoing interest in new devices that have high success rates and are easily learned. The pediatric Airtraq (AT) is a recently developed intubation device that allows visualization of the glottis and intubation of the trachea without alignment of the oral, pharyngeal and tracheal axes. We studied the efficacy of the AT compared to the DL for laryngoscopy of young children with normal airway anatomy. In this prospective study, 49 children (5 yr and younger) scheduled for elective surgery under general anesthesia were randomized into two groups: intubation using direct laryngoscopy (DL group) and laryngoscopy using the Airtraq (AT group). Time to best view, time to intubate, first attempt success rate (FASR), and percentage of glottic opening seen (percentage of glottis opening score) were recorded. Data are presented as median and interquartile range. Time to best view was five (4, 7) sec in DL and five (4, 7.5) sec in AT. Time to intubate was 18 (14.7, 21) sec in DL and 22.5 (19.5, 25.5) sec in AT (P = 0.002). FASR was 100% in the DL and 83% in the AT. The percentage of glottis opening score was 80% (range 60–100%) in the DL and 100% (range 100–100%) in the AT (P < 0.001). In young children with normal airway anatomy, the AT provides a better view of the glottis than the standard laryngoscope, but it takes longer to intubate the trachea and the FASR is lower.