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Tracheal intubation with the B onfils fiberscope in the difficult pediatric airway: a comparison with fiberoptic intubation
Author(s) -
Kaufmann Jost,
Laschat Michael,
Engelhardt Thomas,
Hellmich Martin,
Wappler Frank
Publication year - 2015
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12523
Subject(s) - fiberscope , medicine , intubation , airway , tracheal intubation , anesthesia , gold standard (test) , surgery
Summary Background Fiberoptic intubation ( FOI ) is the gold standard for the tracheal intubation in adults with a difficult airway. However, this technique is more difficult in the narrow pediatric airway and the evaluation of alternative devices in children remains desirable. The Bonfils fiberscope ( BF ) is well described for the difficult airway, but no clinical data assessing its use in the difficult pediatric airway are available. Methods A controlled clinical study was conducted comparing BF and FOI in children and infants requiring tracheal intubation with a suspected difficult airway or who demonstrated a difficult airway which was unanticipated. Time to successful intubation, quality of imaging and ease of the intubation procedure were determined. Results A total of 26 patients (46% infants) were studied, and all successfully intubated at the first attempt using either the BF or FOI . Mouth opening was restricted in 38% of patients. Time required for intubation was shorter with the BF (52 ± 22 s) compared with the FOI (83 ± 24 s, P = 0.008). The image quality (excellent in 73% vs 45%, P = 0.129) and the ease of the procedure (excellent in 67% vs18%, P = 0.015) were considered better with BF than with FOI . Conclusion Although both the BF and FOI are suitable devices for the intubation of infants and children with difficult airways, the BF may allow faster tracheal intubation with a better image quality and ease of use.