Guideline update: Neonatal and infant airway management
When managing a neonate or infant airway, always use history and physical exam findings to predict difficulty upfront. Prioritize videolaryngoscopy for intubation when possible, and remember that apneic oxygenation is recommended during attempts. Always confirm tube placement with end-tidal capnography; this helps minimize the risk associated with multiple failed passes.
The latest joint guidelines from the European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia provide updated recommendations for managing airways in neonates and infants, acknowledging significant anatomical and physiological differences compared to adults. A key focus is on proactively predicting difficult airways using a thorough history and physical examination before any intervention. The guidelines strongly advocate for videolaryngoscopy as the preferred method for intubation when feasible. Furthermore, they emphasize the utility of apneic oxygenation during attempts and stress the importance of confirming tube placement via end-tidal capnography to minimize procedural complications.