Utilizing Video versus Direct Laryngoscopy to Intubate Simulated Newborns while Contained within the Incubator: A Randomized Crossover Study

Yuri Ozawa; Shigehiro Takahashi; Humiko Miyahara; Kenichiro Hosoi; Mazumi Miura; Naho Morisaki; Yushi Ito; Tetsuya Isayama

doi:10.1055/s-0039-1683957

American Journal of Perinatology, Table of Contents

Am J Perinatol 2020; 37(05): 519-524
DOI: 10.1055/s-0039-1683957

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Utilizing Video versus Direct Laryngoscopy to Intubate Simulated Newborns while Contained within the Incubator: A Randomized Crossover Study

Authors

Yuri Ozawa

¹Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
Shigehiro Takahashi

¹Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
Humiko Miyahara

¹Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan

²Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan
Kenichiro Hosoi

³Department of Pediatrics, Kyorin University School of Medicine, Tokyo, Japan
Mazumi Miura

²Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan
Naho Morisaki

⁴Department of Social Medicine, Research Institute, National Center for Child Health and Development, Tokyo, Japan
Yushi Ito

¹Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
Tetsuya Isayama

¹Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan

Abstract

Objective The use of video laryngoscopy for intubating neonates in ergonomically challenging settings has not been studied well. We aimed to assess the usefulness of video laryngoscopy for experienced neonatologists to intubate neonatal manikins in incubators via side hand ports or head window.

Study Design In this randomized crossover trial at three neonatal intensive care units in Japan, 27 neonatologists were randomized into two groups, namely, those intubating neonatal simulators using video laryngoscopy and then using direct laryngoscopy, or vice versa. The intubations were performed via hand ports or head window without opening top and side walls in incubators in two manikin positions (rotated 90° or unrotated). Glottis visualization (0–100%), success rate, intubation time, and ease of laryngoscopy (from 1 [very difficult] to 10 [very easy]) were compared between video laryngoscopy and direct laryngoscopy. Generalized linear models were used for the analyses.

Results This study assessed 108 intubations performed by 27 neonatologists. The use of video laryngoscopy improved the glottis visualization by 14% (95% confidence interval, 7.4–20%; p < 0.01) and easiness scores of laryngoscopy by 0.8 (0.2–1.4; p < 0.01), but did not reduce the intubation time.

Conclusion Video laryngoscopy is useful for experienced neonatologists for intubating neonatal manikins in incubators without opening the top or side walls.

Keywords

video laryngoscopy - neonatal intensive care units - incubator - intubation

Full Text

References

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