Bai Wenyu, Koppera Prabhat, Yuan Yuan, Mentz Graciela, Pearce Bridget, Therrian Megan, Reynolds Paul, Brown Sydney E S
Department of Anesthesiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Paediatr Anaesth. 2025 Jun;35(6):460-468. doi: 10.1111/pan.15079. Epub 2025 Feb 5.
Videolaryngoscopy (VL) and apneic oxygenation are highly recommended and increasingly used in pediatric anesthesia practice; yet, availability, use in recommended clinical settings (e.g., neonates, airway emergencies, and out-of-operating-room tracheal intubation), and the association of VL availability with how pediatric anesthesiologists define difficult intubation have not been explored.
An electronic survey was distributed to the members of several international pediatric anesthesia societies to examine the availability and practice patterns of VL and to explore the criteria used to define a difficult tracheal intubation in children in the context of VL.
The response rate was 12.9%. VL was reported to be "most likely available" in main pediatric operating rooms and offsite locations 93% and 80.1% of the time, respectively. Fifty-seven percent of participants would select VL first when anticipating a difficult tracheal intubation; nearly 30% of respondents would choose direct laryngoscopy first and VL as a backup in this scenario. One-third of subjects would select VL as their first choice for nonoperating room (non-OR) emergency tracheal intubation and for premature or newborn infants, regardless of anticipated difficulty with intubation. Thirty percent of subjects reported using apneic oxygenation during difficult laryngoscopy. Institutional VL availability was not associated with how providers defined difficult tracheal intubation.
VL is highly available, but the adoption of VL and apneic oxygenation for managing difficult tracheal intubation was lower than expected, given recent recommendations by pediatric anesthesia societies. There was heterogeneity in how difficult intubation was defined, resulting in a possible patient safety risk.
视频喉镜检查（VL）和无呼吸给氧在儿科麻醉实践中得到强烈推荐且使用日益增多；然而，其可用性、在推荐临床场景（如新生儿、气道紧急情况和非手术室气管插管）中的使用情况，以及VL的可用性与儿科麻醉医生定义困难插管方式之间的关联尚未得到探讨。
向几个国际儿科麻醉学会的成员发放电子调查问卷，以检查VL的可用性和实践模式，并探讨在VL背景下用于定义儿童困难气管插管的标准。
回复率为12.9%。据报告，VL在主要儿科手术室和非现场地点“最有可能可用”的时间分别为93%和80.1%。57%的参与者在预计气管插管困难时会首先选择VL；近30%的受访者在这种情况下会首先选择直接喉镜检查并将VL作为备用。三分之一的受试者会将VL作为非手术室（非OR）紧急气管插管以及早产或新生儿的首选，无论预计插管难度如何。30%的受试者报告在困难喉镜检查期间使用无呼吸给氧。机构VL的可用性与提供者定义困难气管插管的方式无关。
VL的可用性很高，但根据儿科麻醉学会最近的建议，VL和无呼吸给氧在处理困难气管插管方面的采用率低于预期。在定义困难插管方面存在异质性，可能导致患者安全风险。
