Use of Video Laryngoscope to Reduce Complications of Transesophageal Echocardiography Probe Insertion in Children.

OBJECTIVES

To test the hypothesis of whether using a video laryngoscope reduces complications related to transesophageal echocardiography (TEE) probe insertion in children.

DESIGN

Randomized controlled study.

SETTING

Pediatric cardiac surgical operating rooms in a tertiary care level hospital.

PARTICIPANTS

One hundred thirty children aged 0 to 18 years undergoing elective cardiac surgery.

INTERVENTIONS: TEE probe insertion.

MEASUREMENTS AND MAIN

RESULTS

The patients were randomized into 2 groups: conventional (C) group (n = 64) and video laryngoscopy (VL) group (n = 66). The primary endpoint of the study was the incidence of oropharyngeal injury. The secondary endpoints were the number of attempts required for successful TEE probe insertion and the relation between the esophageal inlet and the larynx. The overall incidence of oropharyngeal injuries was 7.7%, with 4 injuries (6.3%) occurring in the C group and 6 injuries (9.1%) occurring in the VL group (p = 0.543). Most children (90.8%) required only 1 attempt to insert the TEE probe, with no significant difference between groups (p = 0.579). A higher percentage increase in mean blood pressure during probe insertion and a higher heart rate increase after probe insertion were observed in the VL group (p < 0.05). The most common relationship with the larynx was posterior (62%), followed by left posterolateral (20.9%) and right posterolateral (17.1%).

CONCLUSIONS

VL does not demonstrate superiority over conventional methods of TEE probe insertion in children regarding injury incidence or first-attempt success rate.