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Comparing Use of the Glidescope Cobalt to Direct Laryngoscopy in Infants

2014-07-23 21:08:07 | BioPortfolio

Summary

Video laryngoscopy has been shown to improve intubation success in adults and children; However, there is little published regarding the use of video laryngoscopes in infants. The Glidescope Cobalt (GC) is a new video laryngoscope designed for use in infants and children. The investigators seek to prospectively compare intubation with the GC to Direct Laryngoscopy (DL) in infants.

Description

Laryngoscopy is a technique by which the laryngeal opening is exposed to facilitate the placement of a breathing tube. It is routinely performed in patients to facilitate care during general anesthesia and is usually a simple procedure to perform; however, in some patients laryngoscopy may be challenging because of variations in anatomy. There are several types of laryngoscope blades currently utilized in clinical practice; the Miller laryngoscope blade is most commonly utilized for infants requiring intubation. This blade design dates back to the 1940's and until recently little has changed in its basic configuration. The last decade has seen the most significant advancement in laryngoscope design with the integration of video technology into laryngoscope blades. Several studies have shown a benefit to using video to guide intubation in adult patients. Some of these include improved airway visualization, decreased time to intubation, the ability to provide guidance to a novice laryngoscopist and decreased force during intubation. Our own studies at CHOP in an infant manikin model and a review of our prospective difficult intubation database suggests that video laryngoscopes may improve visualization and intubation success in infants with difficult intubation as well.

Our clinical experience with video laryngoscopes in children further suggests that less force is required to gain adequate exposure of airway structures as compared to standard direct laryngoscopy. A recent adult study examined the forces applied to the maxillary incisors during intubation and found that video laryngoscopes were associated with a significant decrease in the force applied. Less force could translate to less airway morbidity. This combined with an improvement in view of airway structures, faster intubations and greater success rates may present a strong argument for video laryngoscopy to be the emerging standard for routine airway management in children. Infants and neonates have the highest oxygen consumption rates of any patient population, which results in an acute decline in oxygen saturation during apnea, making this population most likely to see the greatest benefit from video laryngoscopes.

We seek to study the intubation characteristics of a new video laryngoscope, the Glidescope Cobalt in children less than or equal to 1 yr of age. This evaluation would provide insight as to the efficacy of this device in facilitating intubation in infants.

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Conditions

Intubation

Intervention

Miller Laryngoscope, Glidescope Cobalt Video Laryngoscopes

Location

The Children's Hospital of Philadelphia
Philadelphia
Pennsylvania
United States
19104

Status

Not yet recruiting

Source

Children's Hospital of Philadelphia

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-07-23T21:08:07-0400

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