Comparative evaluation of Airtraq™ and GlideScope® videolaryngoscopes for difficult pediatric intubation in a Pierre Robin manikin

Airway management in children is associated with anatomical and physiological challenges compared with adults. Pierre Robin sequence (PRS) is a condition characterized by micrognathia, glossoptosis, and cleft palate and related to a difficult airway. Both the Airtraq and GlideScope (R) have never been previously directly compared in PRS. Our aim was to evaluate the performance of these two airway devices in a PRS manikin for ethical and practical reasons. Between April and July 2017, 26, pediatric intensive care clinical fellows or trainees from a tertiary pediatric center were recruited to participate. In this prospective and randomized crossover trial, all participants first set up the Airtraq and the GlideScope (R) and then used these videolaryngoscopes to intubate an AirSim (R) PRS manikin. Our primary outcome measure was the duration of the successful intubation attempt. Duration of the successful intubation attempt was 18.1 (14.2-34.9 [10.2-51.3]) s for the Airtraq compared to 31.1 (18.7-55.6 [6.2-119]) s for the GlideScope (R) (p=0.045). Setup time was 50.06.9s for the Airtraq and 27.8 +/- 8.6s for the GlideScope (R) (p<0.001).Conclusion: Even though setup time was longer, the characteristics of intubation performance were superior with the Airtraq relative to the GlideScope (R) in an AirSim (R) PRS manikin.