Shabih Manzar, MD
Medicine is a science and art at the same time. This applies to neonatal endotracheal intubation. It is a science that requires a high level of training and once mastered it becomes an artistic skill.
Traditionally neonates are intubated using direct laryngoscope (DL). However, in recent reports, it has been observed that by using Video laryngoscope (VL) comparable outcomes could be obtained. (1,2)
In a recent Cochrane review in the adult population, it was concluded that VL might reduce the number of failed intubations, improve the glottic view and may reduce laryngeal/airway trauma, however no evidence indicates that use of a VL reduces the number of intubation attempts or the incidence of hypoxia or respiratory complications and affects time required for intubation. (3)
Does Video Laryngoscope hold the future in neonatal intubation?
To answer this question and make it a standard of practice more studies are needed. The results of one of these studies will be available next year. This study is a multi-center collaborative sponsored by Children’s Hospital of Philadelphia. (4).
References:
- Nair S, Thomas EJ, Katakam L.Video Laryngoscopy vs. Direct Laryngoscopy in Teaching Neonatal Endotracheal Intubation: A Simulation-Based Study. Cureus. 2017 Jan 6;9(1):e962. doi: 10.7759/cureus.962.
- Grgurich E, Arnemann C, Amon K, Horton R, Carlson JN. Just-in-Time Video Laryngoscopy Versus Direct Laryngoscopy for Neonatal Intubation. J Perinat Neonatal Nurs. 2016 Oct/ Dec;30(4):367-371.
- Lewis SR, Butler AR, Parker J, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. Cochrane Database Syst Rev. 2016 Nov 15;11:CD011136.
- https://clinicaltrials.gov/ct2/show/NCT03194503
Disclosure: The author has no disclosures.