Cargando…

Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department

The aim of this study was to compare the success of first-attempt tracheal intubation in pediatric patients >1-year old performed using video versus direct laryngoscopy and compare the frequency of tracheal intubation–associated events and desaturation among these patients. Prospective observatio...

Descripción completa

Detalles Bibliográficos
Autores principales: Couto, Thomaz Bittencourt, Reis, Amélia Gorete, Farhat, Sylvia Costa Lima, Carvalho, Vitor Emanoel de Lemos, Schvartsman, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505323/
https://www.ncbi.nlm.nih.gov/pubmed/32957386
http://dx.doi.org/10.1097/MD.0000000000022289
_version_ 1783584786272485376
author Couto, Thomaz Bittencourt
Reis, Amélia Gorete
Farhat, Sylvia Costa Lima
Carvalho, Vitor Emanoel de Lemos
Schvartsman, Claudio
author_facet Couto, Thomaz Bittencourt
Reis, Amélia Gorete
Farhat, Sylvia Costa Lima
Carvalho, Vitor Emanoel de Lemos
Schvartsman, Claudio
author_sort Couto, Thomaz Bittencourt
collection PubMed
description The aim of this study was to compare the success of first-attempt tracheal intubation in pediatric patients >1-year old performed using video versus direct laryngoscopy and compare the frequency of tracheal intubation–associated events and desaturation among these patients. Prospective observational cohort study conducted in an Academic pediatric tertiary emergency department. We compared 50 children intubated with Mcgrath Mac video laryngoscope (VL group) and an historical series of 141 children intubated with direct laryngoscopy (DL group). All patients were aged 1 to 18 years. The first attempt success rates were 68% (34/50) and 37.6% (53/141) in the VL and DL groups (P < .01), respectively. There was a lower proportion of tracheal intubation–associated events in the VL group (VL, 31.3% [15/50] vs DL, 67.8% [97/141]; P < .01) and no significant differences in desaturation (VL, 35% [14/50] vs DL 51.8% [72/141]; P = .06). The median number of attempts was 1 (range, 1–5) for the VL group and 2 (range, 1–8) for the DL group (P < .01). Multivariate logistic regression showed that video laryngoscope use was associated with higher chances of first-attempt intubation with an odds ratio of 4.5 (95% confidence interval, 1.9–10.4, P < 0.01). Compared with direct laryngoscopy, VL was associated with higher success rates of first-attempt tracheal intubations and lower rates of tracheal intubation–associated events.
format Online
Article
Text
id pubmed-7505323
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-75053232020-09-24 Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department Couto, Thomaz Bittencourt Reis, Amélia Gorete Farhat, Sylvia Costa Lima Carvalho, Vitor Emanoel de Lemos Schvartsman, Claudio Medicine (Baltimore) 6200 The aim of this study was to compare the success of first-attempt tracheal intubation in pediatric patients >1-year old performed using video versus direct laryngoscopy and compare the frequency of tracheal intubation–associated events and desaturation among these patients. Prospective observational cohort study conducted in an Academic pediatric tertiary emergency department. We compared 50 children intubated with Mcgrath Mac video laryngoscope (VL group) and an historical series of 141 children intubated with direct laryngoscopy (DL group). All patients were aged 1 to 18 years. The first attempt success rates were 68% (34/50) and 37.6% (53/141) in the VL and DL groups (P < .01), respectively. There was a lower proportion of tracheal intubation–associated events in the VL group (VL, 31.3% [15/50] vs DL, 67.8% [97/141]; P < .01) and no significant differences in desaturation (VL, 35% [14/50] vs DL 51.8% [72/141]; P = .06). The median number of attempts was 1 (range, 1–5) for the VL group and 2 (range, 1–8) for the DL group (P < .01). Multivariate logistic regression showed that video laryngoscope use was associated with higher chances of first-attempt intubation with an odds ratio of 4.5 (95% confidence interval, 1.9–10.4, P < 0.01). Compared with direct laryngoscopy, VL was associated with higher success rates of first-attempt tracheal intubations and lower rates of tracheal intubation–associated events. Lippincott Williams & Wilkins 2020-09-18 /pmc/articles/PMC7505323/ /pubmed/32957386 http://dx.doi.org/10.1097/MD.0000000000022289 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle 6200
Couto, Thomaz Bittencourt
Reis, Amélia Gorete
Farhat, Sylvia Costa Lima
Carvalho, Vitor Emanoel de Lemos
Schvartsman, Claudio
Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department
title Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department
title_full Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department
title_fullStr Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department
title_full_unstemmed Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department
title_short Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department
title_sort changing the view: video versus direct laryngoscopy for intubation in the pediatric emergency department
topic 6200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505323/
https://www.ncbi.nlm.nih.gov/pubmed/32957386
http://dx.doi.org/10.1097/MD.0000000000022289
work_keys_str_mv AT coutothomazbittencourt changingtheviewvideoversusdirectlaryngoscopyforintubationinthepediatricemergencydepartment
AT reisameliagorete changingtheviewvideoversusdirectlaryngoscopyforintubationinthepediatricemergencydepartment
AT farhatsylviacostalima changingtheviewvideoversusdirectlaryngoscopyforintubationinthepediatricemergencydepartment
AT carvalhovitoremanoeldelemos changingtheviewvideoversusdirectlaryngoscopyforintubationinthepediatricemergencydepartment
AT schvartsmanclaudio changingtheviewvideoversusdirectlaryngoscopyforintubationinthepediatricemergencydepartment