Fiberoptic Intubation in Children
Conditions
Keywords
supraglottic airway, children, tracheal intubation, fiberoptic bronchoscopy
Brief summary
The goal of this prospective randomized study is to compare the effect of operator experience on the ability to use fiberoptic-guided intubation in children less than two years old, with and without the use of an air-Q as a conduit. The question the investigators are trying to answer is: Does the operator experience make a significant difference in the time for successful fiberoptic guided tracheal intubation with and without the use of an air-Q intubating laryngeal airway?
Detailed description
The aim of this study is to compare the effect of operator experience on the ability to use fiberoptic-guided intubation in children less than two years old, with and without the use of an air-Q as a conduit. The ease and time for placement of the air-Q, fiberoptic grade of laryngeal view, time for fiberoptic tracheal intubation, and peri-operative complications will also be assessed.
Interventions
DEVICEair-Q, followed by fiberoptic intubation
DEVICEFree-hand Fiberoptic Intubation
Fiberoptic tracheal intubation will be performed without use of the air-Q and timed. Laryngeal grade of view will also be assessed
Sponsors
Ann & Robert H Lurie Children's Hospital of Chicago
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Days to 2 Years
Healthy volunteers
Yes
Inclusion criteria
* Healthy (ASA I to III) children who will be intubated as part of their general anesthesia plan for their scheduled surgeries * Age 1 month - 2 years * Weight 1-20 Kg
Exclusion criteria
* Children with active respiratory infection * Known history of difficult mask ventilation * Diagnosis of a congenital syndrome associated with difficult airway management * Airway abnormalities (e.g., laryngomalacia, subglottic stenosis).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time for successful fiberoptic tracheal intubation | Participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours | The time for successful intubation will be from removal of the face mask or disconnection of the circuit from the air-Q until evidence of end-tidal CO2 is confirmed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of attempts to place the Air-Q | Participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours | Number of attempts needed for successful placement will be recorded (maximum of 3 attempts will be considered as a failure) |
| Ease for placement of the air-Q | Participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours | The ease for Air-Q placement will be assessed using a subjective scale |
| Fiberoptic grade of laryngeal view | Participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours | The laryngeal alignment through the devices will be graded using an established scoring system |
| Time to successful placement of the Air-Q | Participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours | Successful placement of the air-Q will start with the removal of the facemask until presence of end-tidal CO2 is confirmed. |
| Number of attempts for fiberoptic tracheal intubation | Participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours | Number of attempts needed for successful fiberoptic tracheal intubation will be recorded (maximum of 3 attempts will be considered as a failure) |
| Ease for fiberoptic tracheal intubation | Participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours | The ease for fiberoptic tracheal intubation will be assessed using a subjective scale |
| Peri-operative complications | Measured at 24 hours after device placement/study initiation | Includes: Complications during the placement of the Air-Q (Laryngospasm, Bronchospasm, Desaturation, etc. Oropharyngolaryngeal morbidity at discharge, participants will be followed for the duration of anesthesia and after surgery, an average of 24 hours. Oropharyngolaryngeal morbidity at 24 hours post-operatively, measured at 24 hours after device placement/study initiation. These will be assessed by the subject's response or parents subjective assesment to standardized questions regarding oropharyngeal complaints such as sore throat, jaw pain, neck discomfort. |
Countries
United States
Outcome results
None listed