Summary of recommendations from the 2024 ESAIC/BJA airway guidelines for neonates and infants^[1]

Assess for potential difficulty with airway management using history and physical examination

Sedate or anesthetize adequately during airway management

Use neuromuscular blockade for intubation unless spontaneous breathing is required

Use VL with a standard blade for first attempt at intubation^*

Use apneic oxygenation during tracheal intubation in neonates, selectively in infants

Consider using a supraglottic airway for rescue oxygenation and ventilation

Limit the number of tracheal intubation attempts

Use a stylet when using a hyperangulated VL blade

Verify correct ETT placement with clinical assessment and ETCO₂ waveform

Consider using respiratory support after extubation (eg, high-flow nasal oxygen, CPAP, or nasal intermittent positive pressure ventilation)

This table shows the major recommendations that appear in the 2024 guideline. For further information, refer to UpToDate content on airway management for pediatric anesthesia.

BJA: British Journal of Anaesthesia; CPAP: continuous positive airway pressure; ESAIC: European Society of Anaesthesiology and Intensive Care; ETCO₂: end tidal carbon dioxide; ETT: endotracheal tube; NMBA: neuromuscular blocking agents; VL: video laryngoscopy.

* Practice varies among UpToDate contributors. Some use VL routinely for first attempt at intubation, whereas others use VL selectively based on patient factors and clinical circumstances.

Reference:

Disma N, Asai T, Cools E, et al. Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines. Br J Anaesth 2024; 132:124.

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Summary of recommendations from the 2024 ESAIC/BJA airway guidelines for neonates and infants[1]

Summary of recommendations from the 2024 ESAIC/BJA airway guidelines for neonates and infants^[1]