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Video laryngoscopy in neonate and infant intubation-a systematic review and meta-analysis

Ilari Kuitunen1,2, Kati Räsänen3,4, Tuomas T Huttunen5,6

  • 1Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. ilari.kuitunen@uef.fi.

European Journal of Pediatrics
|November 20, 2024
PubMed

Insights

Video laryngoscopy improves first attempt intubation success rates in neonates and infants. This method did not increase intubation time but reduced adverse events like desaturation and trauma.

Area of Science:

  • Pediatric Anesthesiology
  • Critical Care Medicine

Background:

  • Video laryngoscopy has demonstrated improved first-pass intubation success and reduced intubation times in adults and older children.
  • The efficacy of video laryngoscopy in neonates and infants requires further investigation.

Approach:

  • A systematic review and meta-analysis was conducted.
  • Included 13 studies involving neonates (age < 29 days) and infants (age < 365 days) requiring intubation.
  • Assessed first attempt success rate, time to intubation, and adverse events using GRADE criteria.

Key Points:

  • Video laryngoscopy use was associated with higher first attempt intubation success rates in both neonates (RR 1.18) and infants (RR 1.06).
  • No significant difference in time to intubation was observed between video and direct laryngoscopy (MD 1.2s).
  • Lower odds of desaturation (OR 0.62) and nasal/oral trauma (OR 0.24) were noted with video laryngoscopy.

Conclusions:

  • Moderate certainty evidence suggests video laryngoscopy enhances first attempt intubation success in neonates and infants.
  • Time to intubation remains comparable between video and direct laryngoscopy.
  • Additional research is recommended to further optimize first intubation success rates in neonates.

Keywords:
Airway managementIntubationNeonatal intensive carePediatric intensive care

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