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. 2022 Aug 2;9(8):1161.
doi: 10.3390/children9081161.

Comparison of the UEscope Video Laryngoscope with the Traditional Direct Laryngoscope in Neonates and Infants: A Randomized Clinical Trial

Min-Suk Chae  1 , Jae-Hee Chung  2 , Jung-Woo Shim  1 , Jae-Sik Park  1 , Jin-Hoon Bae  1 , Hyung-Mook Lee  1
Affiliations

Comparison of the UEscope Video Laryngoscope with the Traditional Direct Laryngoscope in Neonates and Infants: A Randomized Clinical Trial

Min-Suk Chae et al. Children (Basel). .

Abstract

The role of video laryngoscopy in adults is well established, but its role in children is still inconclusive. Previous studies on the UEscope in pediatric patients with difficult airways showed that it could reduce the time to intubation (TTI) compared to a conventional direct laryngoscope. The main objective of the current study was to investigate if the use of the UEscope could reduce the TTI in neonates and infants. Forty patients under 12 months old were recruited from a single tertiary hospital from March 2020 to September 2021 and were randomly assigned to the direct laryngoscope group (n = 19, neonates = 4, infants = 15) or UEscope group (n = 21, neonates = 6, infants = 15). Although the quality of glottic view was comparable in both groups, the TTI was significantly lower in the UEscope group in both the "intention-to-treat" (-19.34 s, 95% confidence interval = -28.82 to -1.75, p = 0.0144) and "as treated" (-11.24 s, 95% confidence interval: -21.73 to 0, p = 0.0488) analyses. The UEscope may be a better choice for tracheal intubation than conventional direct laryngoscope in neonates and infants.

Keywords: child; infant; intubation; laryngoscopes; newborn.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials (CONSORT) diagram.
Figure 2
Figure 2
Scatter plot of Time to intubation (a) TTI, intention to treat (b) TTI, as treated; (*): p-value < 0.05. Abbreviations: TTI, time to intubation; DL, direct laryngoscope group; UE, UEscope group.
Figure 3
Figure 3
Scatter plot of Time to best view (a) TTBV (b) TTBV with the BURP maneuver; (*): p-value < 0.05. Abbreviations: DL, direct laryngoscope group; UE, UEscope group; TTBV, time to best view; BURP, backward, upward, rightward, and posterior pressure.
Figure 4
Figure 4
Scatter plot of the best POGO score (a) POGO score; (b) Best POGO score with the BURP maneuver. Abbreviations: DL, direct laryngoscope group; UE, UEscope group; POGO, percentage of glottis opening; BURP, backward, upward, rightward, and posterior pressure.
Figure 5
Figure 5
Scatter plot of Cormack and Lehane Laryngeal View grade (a) CL grade (b) CL grade with the BURP maneuver. Abbreviations: DL, direct laryngoscope group; UE, UEscope group; CL, Cormack and Lehane Laryngeal View; BURP, backward, upward, rightward, and posterior pressure.
Figure 6
Figure 6
Changes in the best POGO score after the BURP maneuver in each group: (a) Changes in the POGO score after the BURP maneuver in DL; (b) changes in the POGO score after the BURP maneuver in UE. (*): p-value < 0.05. Abbreviations: DL, direct laryngoscope group; UE, UEscope group; POGO, percentage of glottis opening; BURP, backward, upward, rightward, and posterior pressure.
Figure 7
Figure 7
Effect of the BURP maneuver on the CL grade: (a) Changes in the CL grade after the BURP maneuver in the DL; (b) changes in the CL grade after BURP maneuver in the UE; (*): p-value < 0.05; Abbreviations: DL, direct laryngoscope group; UE, UEscope group; CL, Cormack and Lehane Laryngeal View; BURP, backward, upward, rightward, and posterior pressure.
Figure 8
Figure 8
Number of intubation attempts in the DL and UE. (*): p-value < 0.05. Abbreviations: DL, direct laryngoscope group; UE, UEscope group.
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