Airway

C-MAC videolaryngoscope eased arm muscle strain and workload vs Macintosh in simulated difficult airways

In a randomized crossover manikin study of 35 experienced anesthesiologists, direct laryngoscopy produced more brachioradialis activity than C-MAC videolaryngoscopy in normal, locked-jaw (18 vs 12 µV) and rigid-neck scenarios. Direct laryngoscopy was fastest but applied the most incisor force; King Vision carried the highest perceived workload.

Why it matters. Suggests device choice affects operator ergonomics in difficult airways, an under-studied side of airway management.

Limitation. Manikin simulation; results may not translate to patients.

Liberal clear-fluid fasting in children showed no rise in pulmonary aspiration, meta-analysis finds

Across 33 studies with 580,197 children, pooled aspiration incidence was 0.03% under both conventional (≥2 h) and liberal (<2 h) clear-fluid policies (risk ratio 0.77, 95% CI 0.40-1.47). Vomiting occurred in 0.99% vs 0.76%.

Why it matters. Adds reassurance for programs shortening clear-fluid fasting in children, though aspiration is too rare to compare precisely.

Limitation. Very low certainty of evidence, pooling randomized and non-randomized studies.

Cardiac arrest followed 1.2% of PICU intubations, and each extra attempt raised the odds

Among 27,773 intubations in international PICUs and pediatric cardiac ICUs (2015-2023), intubation-associated cardiac arrest occurred in 1.2%. Each additional attempt raised the odds (aOR 1.70), shock (aOR 4.67) and oxygenation failure (aOR 2.29) were strong risk factors, and video laryngoscopy was associated with lower odds (aOR 0.76).

Why it matters. Adds registry evidence for prioritizing first-attempt success, including video laryngoscopy, in critically ill children.

Limitation. Retrospective registry analysis; associations may reflect confounding.

Effect of Neuromuscular Blocking Agent Use on Video Laryngeal Mask Airway Insertion

Phase 4 trial planning 128 participants, sponsored by Hacettepe University. Status: not yet recruiting. Conditions: Airway Management, Laryngeal Mask Airways, Neuromuscular Blockade.