Canadian Journal of Anesthesia

, Volume 48, Issue 7, pp 691–696 | Cite as

Video-intuboscopic assistance is a useful aid to tracheal intubation in pediatric patients

  • Markus Weiss
  • Kirsten Hartmann
  • Joachim Fischer
  • Andreas C. Gerber
Cardiothoracic Anesthesia, Respiration and Airway



To evaluate the efficacy of video-intuboscopic assisted tracheal intubation in a difficult intubation setting.


In 50 pediatric patients (mean age 12.8 ± 3.1 yr, range 6–16 yr) a grade 3 direct laryngoscopic view was simulated. Eight certified registered nurse anesthetists without experience in endoscopie intubation performed tracheal intubation on five or more patients using the video-optical intubation stylet. Time from insertion of the tube into the oral cavity until the tip had passed the vocal cords was recorded. Failed intubation was defined as intubation >60 sec, arterial oxygen saturation < 92% or esophageal intubation. Subjective degree of difficulty was asked from the operators using a Likert-scale.


Forty-six of the 50 patients were successfully intubated within 60 sec and without arterial oxygen desaturation. In four patients, video-assisted tracheal intubation failed due to prolonged intubation time. Intubation times ranged from 10–40 sec (median 15 sec). Mean intubation time in the first patient (24.5 ± 17.3 sec) appeared longer than for the fifth patient (20.8 ± 10.9 sec), but the difference was not statistically significant (P=0.87). Mean estimated degree of difficulty was 3.9 ± 2.1. Subjective estimates of difficulty increased with intubation times (P=0.001).


The video-optical intubation stylet can be considered a valuable aid for tracheal intubation in pediatric patients with a difficult airway.


Tracheal Intubation Difficult Airway Direct Laryngoscopy Intubation Time Difficult Intubation 
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L’assistance vidéoscopique facilite l’intubation endotrachéale des patients pédiatriques



Évaluer l’efficacité de l’intubation endotrachéale assistée par vidéoscope dans le contexte d’une intubation difficile.


Une vision laryngoscopique directe de grade 3 a été simulée chez 50 patients pédiatriques (âge moyen: 12,8 ± 3,1 ans, limites de 6–16 ans). Huit infirmières anesthésistes qualifiées, mais sans expérience en intubation endoscopique, ont réalisé l’intubation endotrachéale de cinq patients ou plus en utilisant le stylet d’intubation vidéo-optique. L’intervalle compris entre l’insertion de la sonde dans la bouche et le moment où la pointe a dépassé les cordes vocales a été noté. L’échec a été défini comme une intubation > 60 s, une saturation du sang artériel en oxygène < 92% ou une intubation œsophagienne. Les opérateurs ont estimé le degré de difficulté subjective selon une échelle de Likert.


Des 50 intubations, 46 ont été réussies en moins de 60 s et sans désaturation du sang artériel en oxygène. Chez quatre patients, l’intubation endotrachéale vidéoscopique a échoué à cause d’un temps d’intubation prolongé. Les temps d’intubation vont de 10–40 s (médiane de 15 s). Le temps moyen d’intubation du premier patient (24,5 ± 17,3 s) a été plus long que celui du cinquième (20,8 ± 10,9 s), mais la différence n’était pas statistiquement significative (P = 0,87). Le degré moyen de difficulté a été de 3,9 ± 2,1. La difficulté d’intubation a été subjectivement estimée plus grande avec le temps d’intubation (P = 0,001).


On peut donc considérer le stylet d’intubation vidéooptique comme un accessoire valable à l’intubation endotrachéale chez les patients pédiatriques dont l’intubation est difficile.


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Copyright information

© Canadian Anesthesiologists 2001

Authors and Affiliations

  • Markus Weiss
    • 1
  • Kirsten Hartmann
    • 2
  • Joachim Fischer
    • 1
  • Andreas C. Gerber
    • 1
  1. 1.Department of AnaesthesiaUniversity Children’s HospitalZurichSwitzerland
  2. 2.Departments of Intensive Care and NeonatologyUniversity Children’s HospitalZurichSwitzerland

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