Validation of the POGO Score for Classification of Videolaryngoscopy in Children - Post-hoc Analysis of the PeDiAC Study (POGO-KIDS)

External Validation of the POGO Score for Classification of Videolaryngoscopic Intubation in Children and Comparison With the Quality of the Glottic View Rated on Visual Analogue Scales - Post-hoc Analysis of the Prospective PeDiAC Study

It has been assumed that the percentage of glottic opening (POGO) score might enhance the classification of videolaryngoscopic tracheal intubation by offering a more objective rating of glottic exposure but studies in children are lacking. This post hoc analysis of the prospective observational PeDiAC study aims to investigate, if classifying difficult videolaryngoscopic tracheal intubation with the POGO score is superior to a subjective rating of the quality of the glottic view on visual analogue scales (VAS). Post hoc video analysis will be performed by multiple independent raters. A secondary aim is to determine the diagnostic performance of the POGO and VAS for the prediction of relevant user- and patient-centered outcomes and to assess the inter-rater reliability of the POGO score.

Study Overview

• Status: Active, not recruiting
• Conditions: Airway Management; Airway Complication of Anesthesia; Intubation; Difficult or Failed; Intubation, Pediatric

• Study Type: Observational
• Enrollment (Actual): 809

Contacts and Locations

Study Locations

• Germany
  • Hamburg, Germany, 20246
    • Department of Anesthesiology, Center for Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Consecutive sampling: Pediatric patients undergoing general anesthesia with videolaryngoscopic tracheal intubation in the study center

Description

Inclusion Criteria:

• Pediatric patients undergoing general anesthesia with tracheal intubation in the study center
• Informed consent obtained
• Age < 18 years

Exclusion Criteria:

• Anesthetist prefers conventional laryngoscopy
• Indication for intubation via a bronchoscope or awake intubation

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Difficult videolaryngoscopic intubation	Defined as a difficult airway alert issued by the airway operator following videolaryngoscopy	1 hour

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Multiple laryngoscopy attempts	More than one laryngoscopy attempt required until airway established	1 hour
Multiple tracheal intubation attempts	More than one tracheal intubation attempt until airway established	1 hour
First attempt success rate	Percentage of successful intubations with one attempt at laryngoscopy and intubation	1 hour
Percentage of glottic opening (POGO) score	Best glottic view obtained during videolaryngoscopy assessed with the POGO score (%)	1 hour
Quality of glottic visualization	Subjective ratings on visual analog scales (0 to 100; higher values indicate better glottic view)	1 hour
Tracheal intubation time	Time until successful tracheal intubation	1 hour
Airway-related adverse events	Laryngospasm; bronchospasm; airway, oral, soft tissue or dental trauma; laryngeal swelling or use of corticosteroids to reduce swelling risk; oesophageal intubation; pulmonary aspiration; and severe hypoxaemia	1 hour
Difficulty of videolaryngoscopic tracheal intubation	Difficulty of videolaryngoscopic tracheal intubation assessed by the PeDiAC score (0-8; higher values indicate increased difficulty)	1 hour
Severe hypoxaemia	Oxygen saturation < 70% or hypoxaemia-related bradycardia	1 hour
Prolonged tracheal intubation	Tracheal intubation time > 90 sec	1 hour

Collaborators and Investigators

• Sponsor: Universitätsklinikum Hamburg-Eppendorf
• Investigators: Principal Investigator: Martin Petzoldt, MD, Universitätsklinikum Hamburg-Eppendorf

Study record dates

Study Major Dates

• Study Start (Actual): April 12, 2021
• Primary Completion (Actual): August 3, 2022
• Study Completion (Estimated): August 1, 2025

Study Registration Dates

• First Submitted: August 3, 2025
• First Submitted That Met QC Criteria: August 3, 2025
• First Posted (Actual): August 11, 2025

Study Record Updates

• Last Update Posted (Actual): August 11, 2025
• Last Update Submitted That Met QC Criteria: August 3, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: POGO score; Pediatric airway management; Videolaryngoscopic intubation
• Other Study ID Numbers: 2025-300614-WF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No