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Technical factors associated with first-pass success during endotracheal intubation in children: analysis of videolaryngoscopy recordings
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  • Published on:
    Identification of technical factors associated with first-pass success of intubation with C-MAC video laryngoscope in children
    • Tian Tian, Anesthetist Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
    • Other Contributors:
      • Bin Hu, Anesthetist
      • Fu-Shan Xue, Professor

    To the Editor
    We have read with great interest the recent article of Miller et al1 determining the technical factors associated with first-pass success (FPS) during endotracheal intubation with C-MAC video laryngoscope (VL) in children. They showed that placement of the blade tip into the epiglottic vallecula regardless of blade types, adequate glottic view and locating the glottic opening within second quintile of video displayer were significantly associated with FPS. Given that paediatric airway management is a great challenge to emergency physicians and the benefits of videolaryngoscopy are often significant in airway management of emergency paediatric patients,2 their findings have potentially clinical implications. Other than limitations described by authors in discussion, however, we noted several methodological issues in their article on which we invited authors to comment.
    First, primary outcome of this study was FPS, which was defined as passage of C-MAC VL into the mouth with the intention of intubation that terminated with successful intubation at first attempt. As described by authors in introduction, however, C-MAC VL is an intubating device with ability to perform both direct and video laryngoscopy using same device. That is, the larynx can be seen either under direct vision or on a monitor when using C-MAC VL.3 This advantage of C-MAC VL makes it exceptionally useful for emergency intubation. For example, in the event of a failed video laryngosc...

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    Conflict of Interest:
    None declared.