VL vs. DL for Pediatric Intubation

November 4, 2019

Written by Clay Smith

Spoon Feed
Video laryngoscopy (VL) was associated with greater odds of first-pass success than direct laryngoscopy (DL) in pediatric patients.

Why does this matter?
VL has been superior to DL in several ED-based observational studies. But studies in children are less clear. What would the large NEAR database show us?

Scope them babies
This was a retrospective study of 625 patients under age 16, about half of which had VL and half DL. Median age was 4. Several different VL devices were used. They found VL had higher first-pass success than DL, 84.0% vs. 74.5%, respectively (OR 1.7; 95%CI 1.3-2.5). VL was also superior to DL when maneuvers such as external laryngeal manipulation, bougie, or ramped position were used. In addition, VL was superior to DL in the pre-planned subgroup analysis of children under 2.

Source
Video versus Direct and Augmented Direct Laryngoscopy in Pediatric Tracheal Intubations. Acad Emerg Med. 2019 Oct 16. doi: 10.1111/acem.13869. [Epub ahead of print]

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Reviewed by Thomas Davis