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• W2308411907 abstract "6 www.thelancet.com/respiratory Vol 4 January 2016 Maybe a two strikes and you are out policy should also be applied to an intubation technique. In the PeDI registry, the choice of airway management was at the discretion of the individual anaesthesiologist, who took into account not only patient factors, personal preferences and tradition of the institution, but also teaching factors. There is no one-size-fi ts-all approach in paediatric anaesthesia, which makes the paediatric diffi cult airway especially hard to study. Neither the success rates of the diff erent intubation techniques (eg, direct laryngoscopy, video laryngoscopy, or fi beroptic) nor the diff erent operator groups (eg, trainee, consultant, or nurse anaesthetist) can be compared in this registry because the underlying patient subgroups are probably very diff erent. For example, a patient with a known impossible direct laryngoscopy is more likely to be planned to receive a fi breoptic intubation next time. Videolaryngoscopy might have been chosen because direct laryngoscopy is diffi cult or for teaching reasons to supervise a trainee. Consultants are more likely to intubate more diffi cult patients on the fi rst attempt compared with trainees. What questions remain—where to next? Which technique should we use in which age group and for which pathology? The one, we most commonly use, the direct laryngoscopy? The fancy one with the beautiful pictures, the videolaryngoscopy, but linked to longer tracheal intubation times and higher failure rates? Or the gold standard, the fi breoptic intubation, which requires signifi cant time and skills in case of an emergency? What endpoints are important? A beautiful view or a tube in the trachea? If videolaryngoscopy, which one of the many types on the market should we use? To answers these, multicentre randomised controlled trials will be needed. Data collected by PeDI could help with the planning of a large randomised controlled trial, and the collaboration established through the registry could serve as a basis for obtaining higher level evidence. Large randomised controlled trials would eliminate a lot of the bias inherent in registries and would provide answers about how to manage diffi cult airways in paediatric anaesthesia." @default.
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• W2308411907 date "2016-01-01" @default.
• W2308411907 modified "2023-09-27" @default.
• W2308411907 title "Whole-genome sequencing of Mycobacterium tuberculosis for rapid diagnostics and beyond" @default.
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