In addition, no study has yet compared the performance of hyperangulated and nonangulated VLs when used by experienced and inexperienced intubators in PRS patients. However, evidence to guide the choice of the most appropriate VL for difficult intubation in infants with Pierre Robin sequence is insufficient. Video laryngoscopy has been shown to be an effective tool in the management of difficult pediatric airway. In a randomized multi-institutional crossover study, Fiadjoe and colleagues even reported comparable first-attempt intubation success of Glidescope ® Cobalt video laryngoscopy and fiberoptic bronchoscopy when used in a Pierre Robin manikin.
#Collagenopathy with pierre robin sequence mac
In addition, VLs, including the C-MAC ®, the Airtraq ®, the McGrath MAC ™ and the Glidescope ® have been successfully used in pediatric patients with PRS. Due to different blade sizes, these devices can also be used for the management of a difficult airway in infants and newborns. In recent years, however, several video laryngoscopes (VLs) suitable for pediatric patients have been developed and implemented in clinical practice. Therefore, for difficult pediatric airway management, it is imperative to use the most appropriate airway device to increase the probability of success on the first tracheal intubation attempt.Īlthough fiberoptic-guided intubation under spontaneous breathing is considered the gold standard for anticipated difficult airway management, its use in small infants or in potentially uncooperative older children may be challenging. In addition, multiple intubation attempts in children with difficult tracheal intubation have been shown to correlate with a higher rate of failure and an increased incidence of severe complications including hypoxemia and cardiac arrest. Airway management problems are a major contributor to anesthesia associated morbidity and mortality in pediatric patients. In a retrospective chart review including 51 infants with mandibular hypoplasia, Frawley and colleagues described an incidence of difficult intubation of even 71%. Mao and colleagues reported difficult intubation in 57% of patient with PRS requiring mandibular distraction osteogenesis. Due to the congenital craniofacial anomalies, airway management for general anesthesia or acute respiratory distress in uncorrected PRS patients can present significant challenges even for experienced anesthesiologists. Pediatric patients with PRS require general anesthesia for a variety of surgical procedures including tongue lip adhesion, mandibular distraction osteogenesis, tracheostomy and gastrostomy tube placement. Pierre Robin syndrome (PRS), which occurs in approximately 1:5000–1:85000 live births, is characterized by the clinical triad of micrognathia, glossoptosis and upper airway obstruction, and is often associated with cleft palate. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the manuscript and its Supporting Information files.įunding: The authors received no specific funding for this work.Ĭompeting interests: The authors have declared that no competing interests exist. Received: DecemAccepted: ApPublished: April 22, 2021Ĭopyright: © 2021 Moritz et al. PLoS ONE 16(4):Įditor: Tai-Heng Chen, Kaohsuing Medical University Hospital, TAIWAN Citation: Moritz A, Holzhauser L, Fuchte T, Kremer S, Schmidt J, Irouschek A (2021) Comparison of Glidescope Core, C-MAC Miller and conventional Miller laryngoscope for difficult airway management by anesthetists with limited and extensive experience in a simulated Pierre Robin sequence: A randomized crossover manikin study.
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