{
  "abstract": "Editor’s choice is the systematic review and meta-analysis of video vs direct laryngoscopy for urgent tracheal intubation in neonates authored by Niall Donaldson and colleagues. The review included articles where the intubations took place in the neonatal unit or delivery room and excluded studies from other locations. Six studies were included spanning the years 2015–2024 and reporting 863 intubation episodes. Any videolaryngoscope could be used and the studies used a range of instruments. All grades of intubator were included. The use of videolaryngoscopy compared with direct laryngoscopy showed without heterogeneity an increased first attempt success rate (relative risk (RR) 1.45, 95% CI 1.21 to 1.75), with a number needed to treat of six. A sub-group analysis restricted to trainee intubators showed similar results. There were too few intubations for an analysis of consultant intubators. An accompanying editorial by Brett Manley and Shiraz Badurdeen discusses this article and the article by Kathleen Miller and colleagues entitled Success and Safety of Neonatal Endotracheal Tube Exchanges: a NEAR4NEOS Multicentre Retrospective Cohort Study, that was published in the September issue of the journal. 1 In that article Kathleen Miller and colleagues compared the outcomes of 1572 planned endotracheal tube exchanges that occurred in the neonatal unit, with those of 9999 primary intubations. The data came from 21 academic centres in the USA, Canada, Europe, Asia and Australia. The first attempt success rate for primary intubations was 53.6%. The success rate was higher for planned exchanges (70.5%), where the use of paralysing agents and videolaryngscopy were more common. Brett Manley and Shiraz Badurdeen call for videolaryngoscopy to become the standard of care for all neonatal intubations, and this is also the view of the authors of the meta-analysis. Devices are now available with blade sizes that allow use in infants of all sizes and that include options for single-use disposable blades. These studies took place in academic centres where levels of expertise and supervision may be greater than elsewhere and there is room for large scale descriptions of the success of wider implementation to further enhance the evidence base. See pages F526 and F524",
  "authors": [
    {
      "affiliations": [
        "Consultant Neonatologist, Simpson Centre for Reproductive Health, Edinburgh, Edinburgh, UK"
      ],
      "name": "Ben J Stenson"
    }
  ],
  "title": "Fantoms",
  "uid": "ecf1318d-82fe-58a6-b53b-46fca1fb5bc0"
}