Comparison of the GlideScope Cobalt and Storz DCI Video Laryngoscopes in Children Younger Than 2 Years of Age During Manual In-Line Stabilization: A Randomized Trainee Evaluation Study

Marissa Vadi, Katie J. Roddy, Elizabeth A. Ghazal, Michael Um, Andrew J. Neiheisel, Richard Lee Applegate

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVES: Video laryngoscopy facilitates tracheal intubation during manual in-line stabilization in adults, but it is not clear whether these findings translate to children. We compared trainee intubation times obtained using the GlideScope Cobalt and Storz DCI video laryngoscopes versus direct laryngoscopy in young children with immobilized cervical spines. METHODS: Ninety-three children younger than 2 years underwent laryngoscopy with manual in-line stabilization using direct laryngoscopy, GlideScope Cobalt video laryngoscopy, or Storz DCI video laryngoscopy. Laryngoscopists were anesthesiology trainees in postgraduate training year of 3 or more. Total time to successful intubation (TTSI), best glottic view, and maximum degrees of neck deviation were recorded. An intubation time difference longer than 10 seconds was defined as clinically significant. RESULTS: Data are reported as median; 95% confidence interval. The TTSI was similar among groups although Storz times were longer (median, 33.3 seconds; 95% confidence interval, 26.2–43.3 seconds) when compared to direct laryngoscopy (median, 23.3 seconds; 95% confidence interval, 20.7–26.5 seconds; P = 0.02). Obtaining a grade 1 Cormack-Lehane glottic view was less likely with direct laryngoscopy (P = 0.002). Maximum degrees of neck deviation were: Storz (median, 2.0; 95% confidence interval, 1.2–2.8), GlideScope (median, 2.0; 95% confidence interval, 1.4–2.6), and direct laryngoscopy (median, 1.9; 95% confidence interval, 1.2–2.1; P = 0.48). CONCLUSIONS: Trainees were able to safely perform tracheal intubation in children younger than 2 years using any of the studied laryngoscopes, although Storz use resulted in a longer TTSI when compared to direct laryngoscopy. Video laryngoscopy may enhance best Cormack-Lehane glottic view during manual in-line cervical spine immobilization, but additional technical skills are needed to successfully complete tracheal intubation.

Original languageEnglish (US)
JournalPediatric Emergency Care
DOIs
StateAccepted/In press - Jan 16 2016
Externally publishedYes

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Laryngoscopes
Laryngoscopy
Cobalt
Intubation
Confidence Intervals
Tongue
Spine
Neck
Anesthesiology
Immobilization

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

@article{70b7e509c3e64a108a89dd36cfc813b0,
title = "Comparison of the GlideScope Cobalt and Storz DCI Video Laryngoscopes in Children Younger Than 2 Years of Age During Manual In-Line Stabilization: A Randomized Trainee Evaluation Study",
abstract = "OBJECTIVES: Video laryngoscopy facilitates tracheal intubation during manual in-line stabilization in adults, but it is not clear whether these findings translate to children. We compared trainee intubation times obtained using the GlideScope Cobalt and Storz DCI video laryngoscopes versus direct laryngoscopy in young children with immobilized cervical spines. METHODS: Ninety-three children younger than 2 years underwent laryngoscopy with manual in-line stabilization using direct laryngoscopy, GlideScope Cobalt video laryngoscopy, or Storz DCI video laryngoscopy. Laryngoscopists were anesthesiology trainees in postgraduate training year of 3 or more. Total time to successful intubation (TTSI), best glottic view, and maximum degrees of neck deviation were recorded. An intubation time difference longer than 10 seconds was defined as clinically significant. RESULTS: Data are reported as median; 95{\%} confidence interval. The TTSI was similar among groups although Storz times were longer (median, 33.3 seconds; 95{\%} confidence interval, 26.2–43.3 seconds) when compared to direct laryngoscopy (median, 23.3 seconds; 95{\%} confidence interval, 20.7–26.5 seconds; P = 0.02). Obtaining a grade 1 Cormack-Lehane glottic view was less likely with direct laryngoscopy (P = 0.002). Maximum degrees of neck deviation were: Storz (median, 2.0; 95{\%} confidence interval, 1.2–2.8), GlideScope (median, 2.0; 95{\%} confidence interval, 1.4–2.6), and direct laryngoscopy (median, 1.9; 95{\%} confidence interval, 1.2–2.1; P = 0.48). CONCLUSIONS: Trainees were able to safely perform tracheal intubation in children younger than 2 years using any of the studied laryngoscopes, although Storz use resulted in a longer TTSI when compared to direct laryngoscopy. Video laryngoscopy may enhance best Cormack-Lehane glottic view during manual in-line cervical spine immobilization, but additional technical skills are needed to successfully complete tracheal intubation.",
author = "Marissa Vadi and Roddy, {Katie J.} and Ghazal, {Elizabeth A.} and Michael Um and Neiheisel, {Andrew J.} and Applegate, {Richard Lee}",
year = "2016",
month = "1",
day = "16",
doi = "10.1097/PEC.0000000000000607",
language = "English (US)",
journal = "Pediatric Emergency Care",
issn = "0749-5161",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Comparison of the GlideScope Cobalt and Storz DCI Video Laryngoscopes in Children Younger Than 2 Years of Age During Manual In-Line Stabilization

T2 - A Randomized Trainee Evaluation Study

AU - Vadi, Marissa

AU - Roddy, Katie J.

AU - Ghazal, Elizabeth A.

AU - Um, Michael

AU - Neiheisel, Andrew J.

AU - Applegate, Richard Lee

PY - 2016/1/16

Y1 - 2016/1/16

N2 - OBJECTIVES: Video laryngoscopy facilitates tracheal intubation during manual in-line stabilization in adults, but it is not clear whether these findings translate to children. We compared trainee intubation times obtained using the GlideScope Cobalt and Storz DCI video laryngoscopes versus direct laryngoscopy in young children with immobilized cervical spines. METHODS: Ninety-three children younger than 2 years underwent laryngoscopy with manual in-line stabilization using direct laryngoscopy, GlideScope Cobalt video laryngoscopy, or Storz DCI video laryngoscopy. Laryngoscopists were anesthesiology trainees in postgraduate training year of 3 or more. Total time to successful intubation (TTSI), best glottic view, and maximum degrees of neck deviation were recorded. An intubation time difference longer than 10 seconds was defined as clinically significant. RESULTS: Data are reported as median; 95% confidence interval. The TTSI was similar among groups although Storz times were longer (median, 33.3 seconds; 95% confidence interval, 26.2–43.3 seconds) when compared to direct laryngoscopy (median, 23.3 seconds; 95% confidence interval, 20.7–26.5 seconds; P = 0.02). Obtaining a grade 1 Cormack-Lehane glottic view was less likely with direct laryngoscopy (P = 0.002). Maximum degrees of neck deviation were: Storz (median, 2.0; 95% confidence interval, 1.2–2.8), GlideScope (median, 2.0; 95% confidence interval, 1.4–2.6), and direct laryngoscopy (median, 1.9; 95% confidence interval, 1.2–2.1; P = 0.48). CONCLUSIONS: Trainees were able to safely perform tracheal intubation in children younger than 2 years using any of the studied laryngoscopes, although Storz use resulted in a longer TTSI when compared to direct laryngoscopy. Video laryngoscopy may enhance best Cormack-Lehane glottic view during manual in-line cervical spine immobilization, but additional technical skills are needed to successfully complete tracheal intubation.

AB - OBJECTIVES: Video laryngoscopy facilitates tracheal intubation during manual in-line stabilization in adults, but it is not clear whether these findings translate to children. We compared trainee intubation times obtained using the GlideScope Cobalt and Storz DCI video laryngoscopes versus direct laryngoscopy in young children with immobilized cervical spines. METHODS: Ninety-three children younger than 2 years underwent laryngoscopy with manual in-line stabilization using direct laryngoscopy, GlideScope Cobalt video laryngoscopy, or Storz DCI video laryngoscopy. Laryngoscopists were anesthesiology trainees in postgraduate training year of 3 or more. Total time to successful intubation (TTSI), best glottic view, and maximum degrees of neck deviation were recorded. An intubation time difference longer than 10 seconds was defined as clinically significant. RESULTS: Data are reported as median; 95% confidence interval. The TTSI was similar among groups although Storz times were longer (median, 33.3 seconds; 95% confidence interval, 26.2–43.3 seconds) when compared to direct laryngoscopy (median, 23.3 seconds; 95% confidence interval, 20.7–26.5 seconds; P = 0.02). Obtaining a grade 1 Cormack-Lehane glottic view was less likely with direct laryngoscopy (P = 0.002). Maximum degrees of neck deviation were: Storz (median, 2.0; 95% confidence interval, 1.2–2.8), GlideScope (median, 2.0; 95% confidence interval, 1.4–2.6), and direct laryngoscopy (median, 1.9; 95% confidence interval, 1.2–2.1; P = 0.48). CONCLUSIONS: Trainees were able to safely perform tracheal intubation in children younger than 2 years using any of the studied laryngoscopes, although Storz use resulted in a longer TTSI when compared to direct laryngoscopy. Video laryngoscopy may enhance best Cormack-Lehane glottic view during manual in-line cervical spine immobilization, but additional technical skills are needed to successfully complete tracheal intubation.

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DO - 10.1097/PEC.0000000000000607

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