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Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review

INTRODUCTION: Endotracheal intubation and positive pressure ventilation following delivery are required in 32.9% of neonates <31 weeks gestational age and in 5.9% of older newborn babies [1]. Competency in intubation is important, yet opportunities for learners to develop this skill in the clinic...

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Autores principales: MacKinnon, Jenna, McCoy, Carolyn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Canadian Society of Respiratory Therapists 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10089680/
https://www.ncbi.nlm.nih.gov/pubmed/37056577
http://dx.doi.org/10.29390/cjrt-2022-056
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author MacKinnon, Jenna
McCoy, Carolyn
author_facet MacKinnon, Jenna
McCoy, Carolyn
author_sort MacKinnon, Jenna
collection PubMed
description INTRODUCTION: Endotracheal intubation and positive pressure ventilation following delivery are required in 32.9% of neonates <31 weeks gestational age and in 5.9% of older newborn babies [1]. Competency in intubation is important, yet opportunities for learners to develop this skill in the clinical environment are limited. Direct laryngoscopy (DL) provides a direct view of the airway during intubation. Unfortunately, visualization of the airway is only available to the primary operator, preventing supervising instructors from simultaneously viewing the airway and allowing them to provide real-time feedback to learners. Video laryngoscopy (VL) is a specialized clinical instrument that utilizes an indirect view of the airway that is digitally projected onto a screen via camera, which allows multiple simultaneous viewers to view the airway during intubation attempts and permits instructors to provide real-time feedback to learners accordingly. OBJECTIVES: This systematic review explores whether VL-supported learning is superior to DL for the development of skill in neonatal intubation. METHODS: Systematic searches of MEDLINE, EMBASE, CINAHL and the Cochrane Library were conducted without language restrictions. Studies published between January 2011 and November 2021 were examined. Randomized controlled trials (RCTs) comparing the effectiveness of VL versus DL for supporting neonatal intubation learning were included. Rate of successful intubation was the primary outcome measure. Both authors independently extracted study data and conducted risk of bias assessment. RESULTS: Four RCTs met the inclusion criteria, with two incorporating crossover designs. Each examined the effectiveness of VL versus DL, with concurrent supervisor support, as a tool for learning neonatal intubation in medical residents. All studies reported significantly higher intubation success rates with VL. CONCLUSION: VL and real-time supervisor feedback is a more effective tool for supporting the development of neonatal intubation skill, compared with DL. Future investigations should include learners from other professions whose scope of practice includes neonatal intubation (eg, respiratory therapists).
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spelling pubmed-100896802023-04-12 Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review MacKinnon, Jenna McCoy, Carolyn Can J Respir Ther Review Article INTRODUCTION: Endotracheal intubation and positive pressure ventilation following delivery are required in 32.9% of neonates <31 weeks gestational age and in 5.9% of older newborn babies [1]. Competency in intubation is important, yet opportunities for learners to develop this skill in the clinical environment are limited. Direct laryngoscopy (DL) provides a direct view of the airway during intubation. Unfortunately, visualization of the airway is only available to the primary operator, preventing supervising instructors from simultaneously viewing the airway and allowing them to provide real-time feedback to learners. Video laryngoscopy (VL) is a specialized clinical instrument that utilizes an indirect view of the airway that is digitally projected onto a screen via camera, which allows multiple simultaneous viewers to view the airway during intubation attempts and permits instructors to provide real-time feedback to learners accordingly. OBJECTIVES: This systematic review explores whether VL-supported learning is superior to DL for the development of skill in neonatal intubation. METHODS: Systematic searches of MEDLINE, EMBASE, CINAHL and the Cochrane Library were conducted without language restrictions. Studies published between January 2011 and November 2021 were examined. Randomized controlled trials (RCTs) comparing the effectiveness of VL versus DL for supporting neonatal intubation learning were included. Rate of successful intubation was the primary outcome measure. Both authors independently extracted study data and conducted risk of bias assessment. RESULTS: Four RCTs met the inclusion criteria, with two incorporating crossover designs. Each examined the effectiveness of VL versus DL, with concurrent supervisor support, as a tool for learning neonatal intubation in medical residents. All studies reported significantly higher intubation success rates with VL. CONCLUSION: VL and real-time supervisor feedback is a more effective tool for supporting the development of neonatal intubation skill, compared with DL. Future investigations should include learners from other professions whose scope of practice includes neonatal intubation (eg, respiratory therapists). Canadian Society of Respiratory Therapists 2023-04-11 /pmc/articles/PMC10089680/ /pubmed/37056577 http://dx.doi.org/10.29390/cjrt-2022-056 Text en https://creativecommons.org/licenses/by-nc/4.0/This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact editor@csrt.com
spellingShingle Review Article
MacKinnon, Jenna
McCoy, Carolyn
Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review
title Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review
title_full Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review
title_fullStr Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review
title_full_unstemmed Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review
title_short Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review
title_sort use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: a systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10089680/
https://www.ncbi.nlm.nih.gov/pubmed/37056577
http://dx.doi.org/10.29390/cjrt-2022-056
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