Video laryngoscopy guided glottic view grading and its correlation with tracheal intubation time in infants undergoing surgery. A prospective observational study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 87
- Locations
- 1
- Primary Endpoint
- The incidence of Video laryngoscopy-guided glottic view grading(easy & restricted)
Study Overview
Brief Summary
Airway management in infants is one of the most critical and technically challenging
aspects of pediatric anesthesia. Infants present unique anatomical and physiological
characteristics that can complicate tracheal intubation, including a larger tongue, a
more cephalad and anterior larynx, and a narrower airway lumen. These factors
contribute to a higher risk of failed or prolonged intubation, with potential for
significant morbidity such as hypoxemia, bradycardia, and airway trauma. Therefore,
optimizing the visualization of the glottis and understanding its relationship with
intubation outcomes is essential for improving the safety and efficacy of airway
management in this vulnerable population.
Video laryngoscopy (VL) has gained widespread acceptance in pediatric anesthesia
and critical care settings due to its ability to provide enhanced visualization of the
glottis compared to traditional direct laryngoscopy (DL). Unlike DL, which relies
on a direct line of sight, VL offers an indirect view of the airway structures via a
camera at the tip of the laryngoscope blade. This improved view can lead to better
glottic visualization, potentially increasing the success rate of tracheal intubation and
decreasing the time required to secure the airway.[7] Despite these advantages, the predictive value of videolaryngoscopic glottic view grading on intubation outcomes,
particularly in infants, remains underexplored.
Several grading systems, such as the Cormack-Lehane (CL) classification, are
commonly used to describe glottic views during laryngoscopy. However, these
systems were originally developed for adults and direct laryngoscopy, which may
limit their applicability in infants or with videolaryngoscopy. Recently, a specific six-
stage glottic view grading for videolaryngoscopy has been proposed to better capture
the nuances of VL-based airway assessments. Despite this progress, there is a
paucity of prospective data examining the relationship between glottic view grading
and actual intubation performance, including time to successful tube placement, in
the infant population.
This prospective observational study aims to evaluate the correlation between video
laryngoscopy-guided glottic view grading and tracheal intubation time in infants
undergoing elective surgery. By systematically recording and analyzing
videolaryngoscopic views and timing data, we aim to determine whether glottic view
grading can serve as a reliable predictor of intubation difficulty and duration
Study Design
- Study Type
- Observational
Eligibility Criteria
- Ages
- 0.00 Month(s) to 12.00 Month(s) (—)
- Sex
- All
Inclusion Criteria
- •Infants aged 0 to 12 months undergoing elective or emergency surgery requiring endotracheal intubation under general anaesthesia.
- •American Society of Anaesthesiologists status I to IV.
- •Infants with anticipated normal airway anatomy.
- •Written informed consent from parents or guardians.
Exclusion Criteria
- •Infants with known or suspected difficult airway eg craniofacial anomalies , airway malformations, micrognathia.
- •Presence of upper airway pathologies such as tumors, trauma, or infections.
- •Previous neck or airway surgeries.
- •Infants with hemodynamic instability or severe cardiopulmonary compromise.
- •Refusal of parental or guardian consent.
Outcomes
Primary Outcomes
The incidence of Video laryngoscopy-guided glottic view grading(easy & restricted)
Time Frame: Till endotracheal intubation
Secondary Outcomes
- Cormack & Lehane grading.(First-attempt success rate which is defined as successful laryngoscopy & intubation)
Investigators
Dr Rakesh Kumar
All India Institute of Medical Sciences, Jodhpur
