Experience with a modified laryngoscope in sick infants

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Abstract
Critically ill infants receiving supplemental oxygen for their hypoxemia may become significantly compromised by hypoxemia and bradycardia when supplemental oxygenation is interrupted to carry out laryngoscopy and tracheal intubation. It would, therefore, be desirable to devise a means of maintaining supplemental oxygenation during the procedure. A modified laryngoscope blade achieved this objective simply and efficiently. A study was performed on 8 newborn infants with hyaline membrane disease(HMD) who required laryngoscopy and tracheal intubation for progressive hypoxemia. All infants were hypoxemic during the procedure of laryngoscopy, breathing room air (mean PaO2 43 torr). The procedure was repeated with the modified blade (mean PaO2 87 torr). No significant bradycardia was noted. The procedure of intubation was less stressful both to the patient and to the operator. It would seem appropriate to use the modified laryngoscope blade in all situations where hypoxemia threatens. It would seem to have a particular place in intubation of the difficult airway.

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