Usefulness of C-curved stylet for intubation with the C-MAC® Miller videolaryngoscope in neonates and infants: a prospective randomized controlled trial

Area of Science:

• Pediatric Anesthesiology
• Airway Management
• Medical Device Innovation

Background:

• Optimizing endotracheal tube (ETT) shape is crucial for successful videolaryngoscope-assisted intubation.
• Conventional hockey stick-shaped stylets may present challenges in pediatric airway management.

Purpose of the Study:

• To compare the tube-handling time between C-curved and hockey stick-shaped stylets in infants and neonates.
• To evaluate the impact of ETT shape on intubation success and ease of use with a specific videolaryngoscope.

Main Methods:

• A prospective randomized controlled study involving 110 infants (< 1 year).
• Participants were randomized to either a hockey stick-curved stylet group or a C-curved stylet group.
• Primary outcome: tube handling time; Secondary outcomes: total intubation time, success rate, tube tip location, and ease of intubation.

Main Results:

• The C-curved stylet group showed significantly shorter tube insertion time (13.3s vs 25.1s) and total intubation duration (19.9s vs 32.8s).
• Higher intubation success within 30s was observed in the C-curved group (87.7% vs 69.8%).
• The C-curved stylet also led to more favorable initial tube tip placement and was rated easier to use.

Conclusions:

• Modifying the endotracheal tube shape to a C-curve can decrease tube handling time in neonates and infants.
• The C-curved stylet offers advantages over the hockey stick-shaped stylet for videolaryngoscope-assisted intubation in pediatric patients.