[Endotracheal intubation with the GlideScope®, the Airtraq®, the McGrath® videolaryngoscope and direct laryngoscopy: a comparative study on an infant manikin]

Abstract

Objective: The primary purpose of this experimental study was to compare intubation times for direct laryngoscopy with a Miller blade and for 3 VL: GlideScope® videolaryngoscope, Airtraq®, and McGrath®.

Methods: Seventy-seven operators, with various experience of pediatric tracheal intubation (from none to expert), performed 10 attempts of orotracheal intubation with each device on an infant manikin. The main outcome was intubation time and secondary outcome was failure rate.

Results: There was a significant decrease in intubation time from the first to the 10th intubation attempt with all devices (P<0.05). This decrease was no more significant following the third attempt with VL and following the fifth attempt with DL. At the time of the 10th attempt, intubation time was significantly shorter with Airtraq® as compared with all the other devices (P<0.05), but the differences were tight. Failure was significantly more frequent with DL.

Conclusion: In this infant manikin model, the learning curve of the different VL was 3 attempts and the Airtraq® VL appears the airway device enabling the quickest orotracheal intubation. These experimental results need to be confirmed by clinical studies in infants and children.

Keywords: Children; Enfant; Intubation; Manikin; Mannequin; Tracheal intubation; Videolaryngoscope; Vidéo-laryngoscope.