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Video Laryngoscopy Improves Intubation on First Attempt in Neonates

Medically reviewed by Carmen Pope, BPharm. Last updated on May 10, 2024.

By Elana Gotkine HealthDay Reporter

FRIDAY, May 10, 2024 -- Among neonates undergoing urgent endotracheal intubation, successful intubation on the first attempt occurs in more neonates undergoing video laryngoscopy than direct laryngoscopy, according to a study published online May 5 in the New England Journal of Medicine to coincide with the annual meeting of the Pediatric Academic Societies, held from May 2 to 6 in Toronto.

Lucy E. Geraghty, from University College Dublin, and colleagues randomly assigned neonates of any gestational age who were undergoing intubation in the delivery room or neonatal intensive care unit to the video-laryngoscopy group or direct-laryngoscopy group (107 patients in each group).

The researchers found that successful intubation on the first attempt occurred in 74 and 45 percent of patients in the video-laryngoscopy and direct-laryngoscopy groups, respectively. The median number of attempts to achieve successful intubation was one and two in the video- and direct-laryngoscopy groups, respectively. During intubation, the median lowest oxygen saturation was 74 percent in the video-laryngoscopy group and 68 percent in direct-laryngoscopy group; the lowest heart rate was 153 and 148 beats/minute, respectively.

"In this trial involving neonates who were undergoing urgent intubation, video laryngoscopy resulted in greater success on the first intubation attempt than direct laryngoscopy," the authors write.

Karl Storz, the company that manufactures the C-MAC Video Laryngoscope, loaned two units for 10 months during the trial.

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