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Pediatr Emerg Care. 2017 Oct 2. doi: 10.1097/PEC.0000000000001296. [Epub ahead of print]

Evaluation of the C-MAC Miller Video Laryngoscope Sizes 0 and 1 During Tracheal Intubation of Infants Less Than 10 kg.

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From the Departments of *Anesthesiology, Intensive Care Medicine and Pain Therapy and †Pediatric Surgery, University Hospital Frankfurt, Frankfurt; ‡Department of Anesthesia, Intensive Care Medicine and Pain Therapy, Main-Kinzig-Clinic, Gelnhausen; and §Department of Anesthesia, Intensive Care Medicine and Pain Therapy, Evangelic Hospital Oldenburg, Oldenburg, Germany.



Video laryngoscopy has primarily been developed to assist in difficult airways. Using video laryngoscopy in pediatric airway management is an up-and-coming topic. The aim of the presented study was to compare the intubation conditions obtained when using the C-MAC video laryngoscope with Miller blades sizes 0 and 1 for standard direct laryngoscopy and indirect laryngoscopy in children weighing less than 10 kg.


This was a prospective study.


The study was performed in a university hospital.


Following ethical approval, 86 infants weighing less than 10 kg and undergoing surgery under general anesthesia were studied prospectively.


Indirect and direct laryngoscopy either with C-MAC Miller blade size 0 or size 1.


First, direct laryngoscopy was performed, and the best obtained view was graded without looking at the video monitor. A second investigator blinded to the view obtained under direct laryngoscopy graded the laryngeal view on the video monitor. Time to intubation, intubation conditions, and intubation attempts were recorded.


In infants less than 10 kg, intubation conditions were excellent. There were no significant differences between the use of Miller blade 0 or 1 in reference to Cormack-Lehane grade, time to intubation, time to best view, or intubation attempts. Comparing direct and indirect intubation conditions using either Miller blade 0 or 1 revealed that the use of indirect laryngoscopy provided a significantly better view (P < 0.05) of the vocal cords. In 3 infants weighing more than 8 kg, the Miller blade 0 was described as too short and narrow for intubation.


Both devices allowed for an excellent visualization of the vocal cords.

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