Comparison of PeDiAC and the Intubation Difficulty Scale in Pediatric Patients Intubated With Videolaryngoscopy (VIDEOPED)

Comparison of the PeDiAC Score and Intubation Difficulty Scale in Pediatric Patients Aged 0-5 Years Undergoing Tracheal Intubation With Videolaryngoscopy

This prospective observational study aims to compare the effectiveness of the Paediatric Videolaryngoscopic Intubation and Difficult Airway Classification (PeDiAC) and the Intubation Difficulty Scale (IDS) in evaluating difficult tracheal intubation in pediatric patients aged 0 to 5 years. Patients undergoing general anesthesia with videolaryngoscopic intubation will be assessed using both scoring systems. The study seeks to determine which system more accurately reflects the difficulty of intubation and serves as a better guide for future anesthetic management, ultimately contributing to improved patient safety.

Study Overview

• Status: Completed
• Conditions: Pediatric Anesthesia; Videolaryngoscopy; Difficult Airway, Videolaryngoscopes; Airway Management Assessment

Detailed Description

This prospective observational study aims to compare the effectiveness of two scoring systems-Paediatric Videolaryngoscopic Intubation and Difficult Airway Classification (PeDiAC) and the Intubation Difficulty Scale (IDS)-in assessing the difficulty of tracheal intubation in pediatric patients aged 0 to 5 years. Pediatric patients undergoing elective or emergency surgery under general anesthesia will be included in the study. All intubations will be performed using a C-MAC videolaryngoscope.

Demographic data such as age, sex, weight, height, ASA physical status, and comorbidities will be recorded. Intraoperative monitoring parameters including peripheral oxygen saturation (SpO₂) and heart rate will also be documented. During intubation, the glottic view will be graded according to the Modified Cormack-Lehane classification.

Additional variables-including the time required to achieve optimal glottic visualization, total intubation time (from insertion of the device to cuff inflation), number of intubation attempts, and any complications (e.g., desaturation, mucosal bleeding)-will be noted.

Following intubation, both the intubating anesthesiologist and an independent observer will assign a subjective difficulty score using a visual analog scale ranging from 0 (extremely easy) to 10 (impossible). Subsequently, PeDiAC and IDS scores will be calculated for each case.

The primary objective is to determine which of the two scoring systems more accurately reflects the actual difficulty of tracheal intubation in this age group and to identify the one that may better guide future airway management strategies-ultimately aiming to improve safety and clinical outcomes in pediatric anesthesia.

• Study Type: Observational
• Enrollment (Actual): 430

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Turkiye
    • Ankara, Turkiye, Turkey (Türkiye)
      • Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

This study will enroll pediatric patients aged 0 to 5 years who are undergoing general anesthesia for elective and emergent surgical procedures requiring tracheal intubation. Patients will be intubated using a videolaryngoscope. Subjects with difficult airway history, emergency surgery, or airway pathology will be excluded. The study aims to compare two scoring systems evaluating intubation difficulty in this age group.

Description

Eligible participants will be pediatric patients aged 0 to 5 years who are undergoing general anesthesia for any surgical procedure. All included patients must undergo tracheal intubation using a videolaryngoscope (C-MAC). Patients must have an ASA physical status classification of I to IV and written informed consent must be obtained from a parent or legal guardian prior to participation.

Inclusion Criteria:

• Pediatric patients between 0 and 5 years of age
• Undergoing general anesthesia for any type of surgical procedure
• ASA physical status classification I to IV
• Written informed consent obtained from parents or legal guardians

Exclusion Criteria:

• Patients undergoing awake fiberoptic intubation
• History of tracheal resection or reconstruction surgery
• Refusal to participate or absence of informed consent

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Pediatric Patients Undergoing Videolaryngoscopic Intubation; This group includes pediatric patients aged 0-5 years undergoing elective or emergency surgery under general anesthesia with videolaryngoscopic intubation. All patients will be evaluated for intubation difficulty using both the PeDiAC and the Intubation Difficulty Scale (IDS).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Comparison of PeDiAC Score and IDS Score for Predicting Difficult Intubation in Children Aged 0-5 Years	This outcome measure evaluates the effectiveness of two scoring systems-PeDiAC and Intubation Difficulty Scale (IDS)-in reflecting the difficulty of tracheal intubation in pediatric patients aged 0 to 5 years. Both scores will be calculated for each patient immediately after intubation. The correlation between each score and the actual intubation experience will be statistically analyzed to determine which scoring system better predicts intubation difficulty.	Immediately after tracheal intubation

Collaborators and Investigators

• Sponsor: Ankara City Hospital Bilkent

Study record dates

Study Major Dates

• Study Start (Actual): August 28, 2025
• Primary Completion (Actual): January 20, 2026
• Study Completion (Actual): January 30, 2026

Study Registration Dates

• First Submitted: August 19, 2025
• First Submitted That Met QC Criteria: August 19, 2025
• First Posted (Actual): August 26, 2025

Study Record Updates

• Last Update Posted (Actual): March 18, 2026
• Last Update Submitted That Met QC Criteria: March 17, 2026
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Videolaryngoscopy; Tracheal intubation; Pediatric anesthesia; Difficult airway; Pediatric intubation; PeDiAC; Intubation Difficulty Scale (IDS); Modified Cormack-Lehane classification
• Other Study ID Numbers: PEDIAC-VL-2025-GID

Drug and device information, study documents

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