Artigo Acesso aberto Revisado por pares

Videolaryngoscope for Teaching Neonatal Endotracheal Intubation: A Randomized Controlled Trial

2016; American Academy of Pediatrics; Volume: 137; Issue: 3 Linguagem: Inglês

10.1542/peds.2015-2156

ISSN

1098-4275

Autores

Ahmed Moussa, Y Luangxay, Sophie Tremblay, Julie Lavoie, G Aube, E Savoie, Christian Lachance,

Tópico(s)

Tracheal and airway disorders

Resumo

To assess whether the videolaryngoscope (VL) is superior to the classic laryngoscope (CL) in acquiring skill in neonatal endotracheal intubation (ETI) and, once acquired with the VL, whether the skill is transferable to the CL.This randomized controlled trial, in a level 3 Canadian hospital, recruited junior pediatric residents who performed ETI in the NICU. The primary outcome was success rate of ETI. Secondary outcomes were time to successful intubation, number of bradycardia episodes andlowest oxygen saturation during procedure, occurrence of mucosal trauma, reason for ETI failure, and recognition of problems related to ETI bysupervisor andresident.In phase 1, 34 pediatric residents performed 213 ETIs by using either VL or CL. Intervention groups were comparable at baseline. The success rate was higher (75.2% vs 63.4%, P = .03), and time to successful intubation was longer, inVL group (57 vs 47 seconds, P = .008). In phase 2, 23 residents performed 55 ETIs using CL. The success rate of residents inVL group performing ETI by using the CL was 63% (compared with 75% in phase 1, P = .16).When learning ETI, the success rate is improved with the VL. Time to successful intubation is longer, but the difference is not clinically significant. When switched to the CL, residents' success rate slightly decreased, but not significantly. This suggests that residents retain a certain level of ETI skill when switched to the CL. The VL is a promising tool for teaching neonatal ETI.

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