Efficacy and safety of videolaryngoscopy-guided verbal feedback to teach neonatal and infant intubation. A prospective randomised cross over study

Saran, Anita; Dave, Nandini; Karnik, Priyanka Pradeep

doi:10.4103/ija.ija_823_18

Cited by 21 publications

(19 citation statements)

References 7 publications

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“…Of the 13 eligible studies, nine were excluded as they investigated the use of VL versus DL in simulations using mannequins or focused on the use of VL for intubation, not as a teaching tool. Four studies met all inclusion criteria for this review: two parallel RCT [ 7 , 10 ] and two RCTs with crossover [ 6 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Characteristics of included studies are summarized in Appendix 2 2 with extracted data in Table 1 . Four RCTs [ 6 , 7 , 10 , 20 ] met the inclusion criteria for this review, with two using crossover designs [ 6 , 20 ]. All four RCTs were conducted in hospital settings of a neonatal intensive care unit (NICU), labour and delivery ward, or operating room.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, a crossover study by Saran et al [ 20 ] analyzed 144 intubations and reported that VL had a significantly higher success rate in both phases of the study (phase 1: VL: 80.5% [29/36], DL: 41.6% [15/36], P≤0.0007; phase 2 [crossover]: VL: 86.1% [31/36], DL: 47.2% [17/36], P≤0.0004). The present study did not provide information on the time between phases.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review

MacKinnon¹,

McCoy²

2023

Can J Respir Ther

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Introduction Endotracheal intubation and positive pressure ventilation following delivery are required in 32.9% of neonates <31 weeks gestational age and in 5.9% of older newborn babies [1]. Competency in intubation is important, yet opportunities for learners to develop this skill in the clinical environment are limited. Direct laryngoscopy (DL) provides a direct view of the airway during intubation. Unfortunately, visualization of the airway is only available to the primary operator, preventing supervising instructors from simultaneously viewing the airway and allowing them to provide real-time feedback to learners. Video laryngoscopy (VL) is a specialized clinical instrument that utilizes an indirect view of the airway that is digitally projected onto a screen via camera, which allows multiple simultaneous viewers to view the airway during intubation attempts and permits instructors to provide real-time feedback to learners accordingly. Objectives This systematic review explores whether VL-supported learning is superior to DL for the development of skill in neonatal intubation. Methods Systematic searches of MEDLINE, EMBASE, CINAHL and the Cochrane Library were conducted without language restrictions. Studies published between January 2011 and November 2021 were examined. Randomized controlled trials (RCTs) comparing the effectiveness of VL versus DL for supporting neonatal intubation learning were included. Rate of successful intubation was the primary outcome measure. Both authors independently extracted study data and conducted risk of bias assessment. Results Four RCTs met the inclusion criteria, with two incorporating crossover designs. Each examined the effectiveness of VL versus DL, with concurrent supervisor support, as a tool for learning neonatal intubation in medical residents. All studies reported significantly higher intubation success rates with VL. Conclusion VL and real-time supervisor feedback is a more effective tool for supporting the development of neonatal intubation skill, compared with DL. Future investigations should include learners from other professions whose scope of practice includes neonatal intubation (eg, respiratory therapists).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review

MacKinnon¹,

McCoy²

2023

Can J Respir Ther

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“…Numerous benefits of VL have been reported, and these include improved laryngeal view, visual confirmation of tube placement, high rates of successful rescue after failure of direct laryngoscopy,[ 2 ] reduction in applied force,[ 8 ] a steep learning curve,[ 9 ] improved training of novices,[ 10 11 ] and improved operator ergonomics,[ 12 ] but evidence of benefit is not available for all devices or all circumstances, making clinical decisions and device choice complex. A systematic Cochrane review comparing VL with direct laryngoscopy reported improved glottic view, reduced intubation failure as well as reduced incidence of laryngeal/airway trauma.…”

Section: Discussionmentioning

confidence: 99%

Role of videolaryngoscope in the management of difficult airway in adults: A survey

Shruthi¹,

Dinakara²,

Chandrika³

2020

Indian J Anaesth

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“…Recent literature[ 19 20 ] has studied the superiority of VL over direct laryngoscopy in neonates and infants by novices and found that novices had higher first-attempt success rate and fewer oesophageal intubations with VL as compared to those with direct laryngoscope-guided intubation. Therefore, the performance of KVL, in terms of first-attempt intubation success rate and complications in paediatric tracheal intubation, when used by trainees and novices, is another important premise which warrants future dedicated research.…”

Section: Discussionmentioning

confidence: 99%

Comparison of paediatric King Vision™ videolaryngoscope and Macintosh laryngoscope for elective tracheal intubation in children of age less than 1 year: A randomised clinical trial

et al. 2020

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Background and Aims: Paediatric airway, because of its consistent anatomical differences from that of an adult, often encounters difficulty in aligning the line of sight with the laryngeal inlet during intubation. Paediatric videolaryngoscopes (VLs), by obviating the need for aligning the line of sight with the glottis, offer several advantages over direct laryngoscopy. Therefore, this study aimed to compare the recently introduced paediatric King Vision™ VL (KVL) and the direct laryngoscope with Macintosh blade for elective tracheal intubation in infants of age <1 year. Methods: Seventy-eight infants of American Society of Anesthesiologists physical status 1 and 2, scheduled for elective surgery, were enrolled for this prospective randomised clinical trial and randomised into either of the two groups – Group K and Group C, where the infants were intubated using size 1 King Vision or direct laryngoscope with Macintosh blade. The primary objective of this study was the time taken for intubation and the first-attempt intubation success rate. Results: Time to intubate (25.90 ± 2.34 s vs. 25.03 ± 1.42 s, P = 0.05) and first-attempt intubation success rate (100% vs. 100%, P = 1) were similar between the groups, whereas glottic visualisation ( P = 0.01), alternate techniques used to assist intubation ( P < 0.001), the ease of intubation ( P = 0.02) and intubation difficulty score ( P = 0.01) were better in Group K than that in Group C. Conclusion: The outcome of KVL and Macintosh laryngoscope was similar in terms of time taken for intubation and first-attempt intubation success rate with KVL having superior glottic visualisation, better ease of intubation and lower intubation difficulty score for elective intubations in children of age <1 year.

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Efficacy and safety of videolaryngoscopy-guided verbal feedback to teach neonatal and infant intubation. A prospective randomised cross over study

Cited by 21 publications

References 7 publications

Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review

Use of video laryngoscopy versus direct laryngoscopy as a teaching tool for neonatal intubation: A systematic review

Role of videolaryngoscope in the management of difficult airway in adults: A survey

Comparison of paediatric King Vision™ videolaryngoscope and Macintosh laryngoscope for elective tracheal intubation in children of age less than 1 year: A randomised clinical trial

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