Figure 1 - uploaded by Deepak Dwivedi
Content may be subject to copyright.
(a) Shows the profile of the child with micrognathia and retruded mandible in a case of "Peter Plus Syndrome". (b) Shows the assembly of Airtraq TM videolaryngoscope with FOB rail roaded with the ETT used in the case for intubation
Source publication
Pediatric difficult airway can be grouped as, difficult
mask ventilation, difficult laryngoscopy/intubation, cannot
intubate and cannot ventilate situation. Incidence of difficult
laryngoscopy and difficult intubation, varies between 0.06%
and 3%[1] and 0.03 to 0.13%[2] respectively. We describe
an anticipated difficult airway in an infant with ‘Pe...
Context in source publication
Context 1
... TM (1.5 size) was inserted but there was a considerable leak, the SGD was removed and the child was mask ventilated with 100% oxygen and depth of anesthesia was maintained with sevoflurane (2-4%) and additional 2 mg IV ketamine was administered. A second attempt of videolaryngoscopy was performed and after reaching epiglottis, it was stabilized in this position and then, the FOB loaded with 4.0 mm ID ETT, was gently passed through the channel of the videolaryngoscope by another trained anesthesiologist [ Figure 1b]. After reaching the summit of the glottis, the tip was manipulated anteriorly, and the CL view changed to II a. ...
Similar publications
Citations
... FOI can be useful for securing the airway in pediatric patients with challenging airways, such as those with congenital abnormalities or other anatomical issues. In such cases, FOI may be the only option for successfully intubating patients [10,11]. Therefore, pediatric anesthesiologists need to acquire proficiency in this technique. ...
... Several case reports indicated the usefulness of VAFI for pediatric patients with certain congenital syndromes known for difficult airways [10]. Thus, a further study evaluating the effectiveness of VAFI for pediatric patients with difficult airways is warranted. ...
Introduction:
Life-threatening hypoxemia during tracheal intubation is more likely to occur in children than adults due to its unique physiological and anatomical nature. Fiberoptic intubation is widely performed in children with difficult airways. However, mastery of fiberoptic intubation requires substantial training, and novice trainees need to attempt fiberoptic intubation in children at high risk of respiratory-related adverse events. Therefore, a safer method than traditional fiberoptic intubation for children with difficult airways is desirable for novice anesthesia trainees. This study aimed to compare the efficacy of video-assisted fiberoptic intubation (VAFI) with that of traditional fiberoptic intubation (FOI) in a high-fidelity pediatric simulator by medical professionals with no experience in tracheal intubation.
Method:
This randomized, controlled, simulation-based study was conducted in a tertiary-care pediatric hospital. Registered nurses working in the operating room were enrolled in this study and randomly assigned to either the FOI or VAFI groups. Participants in the FOI group performed fiberoptic intubation without the aid of any device, whereas those in the VAFI group used a video laryngoscope to obtain a better glottic view. The primary outcome was the time from the moment the tip of the flexible bronchoscope passed between the upper and lower incisors until the completion of tracheal intubation.
Results:
A total of 28 participants were enrolled in this study. There was no significant difference in the time until the completion of tracheal intubation between FOI and VAFI, with a median time of 55.0 seconds for FOI and 42.5 seconds for VAFI (P = 0.22). Secondary outcomes, including time until passing the vocal cord, the number of intubation attempts, and the first success rate, did not also illustrate the significant difference between the groups.
Conclusion:
This study did not demonstrate the superiority of VAFI over conventional FOI in a high-fidelity pediatric simulator by medical providers with no experience in tracheal intubation.
