The difficult pediatric airway--a review of new devices for indirect laryngoscopy in children younger than two years of age

During the last decade, several new look-around-corner or video airway devices have proven useful in clinical adult practice. Only four of them are currently available in sizes that may be used in children younger than 2 years of age: the AIRTRAQ® Disposable Optical Laryngoscope (Prodol Meditec, Vizcaya, Spain), the GlideScope® Video Laryngoscope (Verathon, Bothell, WA, USA), the Storz DCI® Video Laryngoscope (Karl Storz, Tuttlingen, Germany), and the Truview PCD™ Infant (Truphatek, Netanya, Israel). Here, we review the literature and describe the clinical use of each device in this age-group. The four new laryngoscopes are generally effective and may solve many of the problems with difficult intubations in children younger than 2 years of age. The size of the device and the mouth opening it requires determines its usefulness in the smallest infants. Training will be necessary in implementing and deciding when to use the new airway devices, although one of the big challenges of the future will be to maintain the teaching and training of fiber-optic-guided intubations, which remain the gold standard in difficult endotracheal intubations.