Published online July 20, 2009
PEDIATRICS Vol. 124 No. 2 August 2009, pp. e339-e346 (doi:10.1542/peds.2008-3653)
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ARTICLE

A Videolaryngoscopy Technique for the Intubation of the Newborn: Preliminary Report

Andre L. Vanderhal, MDa, George Berci, MDb, Charles F. Simmons, Jr, MDa and Masanobu Hagiike, MDb

a Department of Pediatrics, Division of Neonatology
b Department of Surgery, Minimally Invasive Surgery Research, Cedars-Sinai Medical Center, Los Angeles, California

OBJECTIVE: We describe videolaryngoscopy equipment and technique for endotracheal intubation and airway evaluation in the delivery room (DR) and NICU for endotracheal intubation and airway evaluation. We report our first experience of 47 patients.

METHODS: Forty-seven infants who weighed 530 to 6795 g and required endotracheal intubation or airway evaluation were considered for intubation or assessment by using the modified Kaplan-Berci videolaryngoscope. We report quality-improvement data after initial introduction of newly approved technology.

RESULTS: We report results of 48 intubations in 42 patients and videolaryngoscopic inspection without intubation in 5 patients. Five intubation attempts were successful after failed attempts by experienced intubators; 6 attempts by residents were completed with video guidance rather than requiring an additional attempt. Only 3 intubations required more than 2 attempts. Enlarged panoramic view and recording assisted in correct diagnosis of vocal cord paralysis. The features and main advantages are discussed in detail. No complications or difficulties resulting from the technology occurred.

CONCLUSIONS: This new technique and technology show promise to improve airway management, evaluation, and teaching. Future research to validate improved intubation success in difficult airways and in teaching situations is warranted.

Key Words: videolaryngoscope • newborn • pediatric airway management • difficult airway • intubation technique

Abbreviations: ETT—endotracheal tube • DR—delivery room

Accepted Mar 27, 2009.


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