# Performance of the Bebé VieScope Versus Direct Laryngoscopy During Pediatric Cardiopulmonary Resuscitation: A Prospective Randomized Simulation Study

## TL;DR

In simulated pediatric CPR, the VieScope laryngoscope outperformed traditional tools in first-pass success and intubation time, especially during continuous chest compressions.

## Contribution

Demonstrates the VieScope laryngoscope's superior performance in dynamic resuscitation conditions compared to Macintosh and Miller laryngoscopes.

## Key findings

- VieScope had higher first-pass success rates and shorter intubation times than Macintosh and Miller laryngoscopes during continuous chest compressions.
- Performance differences were minor without chest compressions but significant during dynamic resuscitation conditions.
- VieScope provided better glottic visualization and procedural efficiency in high-movement scenarios.

## Abstract

What are the main findings?
In a simulated pediatric cardiac arrest model, the VieScope laryngoscope had better first-pass success rates and shorter intubation times than the Macintosh and Miller direct laryngoscopes, especially when chest compressions were not stopped.Performance differences between devices were minor without chest compressions but became significant during dynamic resuscitation conditions, with VieScope consistently offering better glottic visualization and procedural efficiency.

In a simulated pediatric cardiac arrest model, the VieScope laryngoscope had better first-pass success rates and shorter intubation times than the Macintosh and Miller direct laryngoscopes, especially when chest compressions were not stopped.

Performance differences between devices were minor without chest compressions but became significant during dynamic resuscitation conditions, with VieScope consistently offering better glottic visualization and procedural efficiency.

What are the implications of the main findings?
Optical tubular laryngoscopes may be helpful as airway management tools during pediatric cardiopulmonary resuscitation, particularly when reducing interruptions to chest compressions is important.Integrating such devices into pediatric airway training and resuscitation protocols could improve intubation performance in difficult, high-movement situations, pending validation in clinical studies.As these results were obtained in a controlled simulation setting, prospective clinical studies are needed to determine whether the observed performance differences translate into improved airway management and outcomes during real pediatric cardiopulmonary resuscitation.

Optical tubular laryngoscopes may be helpful as airway management tools during pediatric cardiopulmonary resuscitation, particularly when reducing interruptions to chest compressions is important.

Integrating such devices into pediatric airway training and resuscitation protocols could improve intubation performance in difficult, high-movement situations, pending validation in clinical studies.

As these results were obtained in a controlled simulation setting, prospective clinical studies are needed to determine whether the observed performance differences translate into improved airway management and outcomes during real pediatric cardiopulmonary resuscitation.

Background/Objectives: Effective airway management during pediatric cardiopulmonary resuscitation (CPR) is crucial but technically challenging, especially during continuous chest compressions. While direct laryngoscopy with Macintosh (MAC) or Miller (MIL) blades remains the standard, optical devices such as the VieScope (VSL) may enhance performance under dynamic resuscitation conditions. This study compared first-pass success and intubation time, as well as procedural difficulty and glottic visualization, of MAC, MIL, and VSL during simulated pediatric cardiopulmonary resuscitation. Methods: This prospective, randomized crossover simulation study involved 53 medical students. Participants performed endotracheal intubation on a high-fidelity manikin simulating a 5-year-old pediatric patient using MAC, MIL, and the Bebé VieScope laryngoscope. Each technique was evaluated in two scenarios: with and without continuous chest compressions. Results: Without chest compressions, first-pass success (FPS) and intubation time varied significantly between techniques. VSL achieved the highest FPS (100%; p = 0.032) and the shortest intubation time (27.9 ± 9.2 s; p = 0.040), performing faster than MIL and achieving higher FPS than MAC. Visualization quality, ease of intubation, and optimization maneuvers were similar across techniques. During continuous chest compressions, all outcomes differed significantly. FPS increased from MAC to MIL and VSL (p = 0.001), with MAC showing the lowest success rate. VSL showed the shortest intubation time (35.9 ± 13.0 s; p < 0.001), better glottic visualization, easier intubation, and fewer optimization maneuvers, followed by MIL. Conclusions: In this simulated pediatric cardiac arrest model, the VieScope laryngoscope demonstrated superior overall performance, especially during uninterrupted chest compressions. Optical tubular laryngoscopy may therefore provide clinically relevant benefits in pediatric resuscitation where maintaining high-quality chest compressions is crucial. Given the manikin-based design of this study, confirmation of these findings in clinical pediatric cardiac arrest settings will require further prospective clinical investigation.