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American Academy of Pediatrics
Article

Augmented Reality–Assisted Video Laryngoscopy and Simulated Neonatal Intubations: A Pilot Study

Patricia L. Dias, Rachel G. Greenberg, Ronald N. Goldberg, Kimberley Fisher and David T. Tanaka
Pediatrics March 2021, 147 (3) e2020005009; DOI: https://doi.org/10.1542/peds.2020-005009
Patricia L. Dias
aDepartment of Pediatrics,
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Rachel G. Greenberg
aDepartment of Pediatrics,
bDuke Clinical Research Institute, and
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Ronald N. Goldberg
aDepartment of Pediatrics,
cJean and George Brumley Jr Neonatal-Perinatal Research Institute, School of Medicine, Duke University, Durham, North Carolina
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Kimberley Fisher
aDepartment of Pediatrics,
cJean and George Brumley Jr Neonatal-Perinatal Research Institute, School of Medicine, Duke University, Durham, North Carolina
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David T. Tanaka
aDepartment of Pediatrics,
cJean and George Brumley Jr Neonatal-Perinatal Research Institute, School of Medicine, Duke University, Durham, North Carolina
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Abstract

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BACKGROUND: For novice providers, achieving competency in neonatal intubation is becoming increasingly difficult, possibly because of fewer intubation opportunities. In the present study, we compared intubation outcomes on manikins using direct laryngoscopy (DL), indirect video laryngoscopy (IVL) using a modified disposable blade, and augmented reality–assisted video laryngoscopy (ARVL), a novel technique using smart glasses to project a magnified video of the airway into the intubator’s visual field.

METHODS: Neonatal intensive care nurses (n = 45) with minimal simulated intubation experience were randomly assigned (n = 15) to the following 3 groups: DL, IVL, and ARVL. All participants completed 5 intubation attempts on a manikin using their assigned modalities and received verbal coaching by a supervisor, who viewed the video while assisting the IVL and ARVL groups. The outcome and time of each attempt were recorded.

RESULTS: The DL group successfully intubated on 32% of attempts compared to 72% in the IVL group and 71% in the ARVL group (P < .001). The DL group intubated the esophagus on 27% of attempts, whereas there were no esophageal intubations in either the IVL or ARVL groups (P < .001). The median (interquartile range) time to intubate in the DL group was 35.6 (22.9–58.0) seconds, compared to 21.6 (13.9–31.9) seconds in the IVL group and 20.7 (13.2–36.5) seconds in the ARVL group (P < .001).

CONCLUSIONS: Simulated intubation success of neonatal intensive care nurses was significantly improved by using either IVL or ARVL compared to DL. Future prospective studies are needed to explore the potential benefits of this technology when used in real patients.

  • Accepted December 1, 2020.
  • Copyright © 2021 by the American Academy of Pediatrics

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Pediatrics
Vol. 147, Issue 3
1 Mar 2021
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Augmented Reality–Assisted Video Laryngoscopy and Simulated Neonatal Intubations: A Pilot Study
Patricia L. Dias, Rachel G. Greenberg, Ronald N. Goldberg, Kimberley Fisher, David T. Tanaka
Pediatrics Mar 2021, 147 (3) e2020005009; DOI: 10.1542/peds.2020-005009

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Augmented Reality–Assisted Video Laryngoscopy and Simulated Neonatal Intubations: A Pilot Study
Patricia L. Dias, Rachel G. Greenberg, Ronald N. Goldberg, Kimberley Fisher, David T. Tanaka
Pediatrics Mar 2021, 147 (3) e2020005009; DOI: 10.1542/peds.2020-005009
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