• Chrystelle Sola, Anne-Charlotte Saour, Christine Macq, Sophie Bringuier, Olivier Raux, and Christophe Dadure.
• Department of Paediatric Anaesthesia and Critical Care Medicine, Montpellier University, Lapeyronie Hospital, CHU Montpellier, 34295 Montpellier cedex 5, France. Electronic address: c-sola@chu-montpellier.fr.
• Anaesth Crit Care Pain Med. 2017 Oct 1; 36 (5): 267-271.

BackgroundGlideScope® video-laryngoscopy is becoming increasingly used, including in paediatrics. However, to date, very few data are available on efficiency during situations involving difficult intubation. Our objective was to describe the usefulness of the GlideScope® in children with presumed challenging airway criteria.MethodsIn this observational study, all children with predicted criteria of potential difficult intubation and requiring general anaesthesia with tracheal intubation were prospectively enrolled over a 12-month period. The Cormack and Lehane (CMK) grade was first assessed by direct laryngoscopy. In case of a CMK≥3, the same experienced anaesthesiologist scored the CMK scale under GlideScope® videoscopy. Data related to GlideScope® use under difficult intubation conditions were analysed.ResultsOut of the sixty-one patients (median [25th-75th interquartile range] age of 12 [4-37] months) included, 37 (62%) patients have confirmed a high probability of difficult intubation. Compared to direct laryngoscopy, GlideScope® video-laryngoscopy was significantly associated with an improved CMK grade (P<0.001). Tracheal intubation with the GlideScope® was successful after the first attempt in almost one half of cases and ultimately in 100% of patients. The median time required for successful GlideScope® intubation was 42.5 [30-60] s. No per procedure complications were recorded.ConclusionIn children with challenging airways, GlideScope® video-laryngoscopy resulted in a significant improvement of the glottic view with an excellent success rate and satisfactory time to intubation. How these devices are to be positioned in difficult airway management algorithms and guidelines remain to be defined.Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

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