Upper Airway Ultrasound to Predict Difficult Laryngoscopy in Neonates and Infants

Enrolling by invitation

Conditions studied: Neonates, Infants Aged 0 Days to 12 Months Scheduled for Elective Surgery

In brief

Upper airway ultrasound (UA-US) has been utilized in adults to predict difficult laryngoscopy (Cormick-Lehane view 3 or 4) and difficult tracheal intubation (DTI) (≥3 intubation attempts) and with moderate-to-high sensitivity and specificity. This bedside technique is reproducible, easy-to-do without any additional radiation risk, and was added to the most recent American Society of Anesthesiologists (ASA) Practice Guidelines for Difficult Airway Management in Adults. However, UA-US has only been applied to older children ages 5-12 and has not been examined in neonates and infants. Thus, the aim of this observational study using UA-US to predict difficult laryngoscopy and tracheal intubation in neonates and infants presenting for diagnostic, procedural or surgical care under general anesthesia requiring endotracheal intubation.

Key facts

Study ID: NCT07444528
Run by: Children's Hospital of Philadelphia
People needed: 180
Starts: 2026-03-02
Expected to finish: 2027-12-31
Last updated by the study team: 2026-03-04

Who can join

Age: any, up to 1. Sex: any. Healthy volunteers: accepted.

You may qualify if…

Neonates (chronological age 30 days) and infants (31 days to 365 days)
ASA physical status I-IV
Oral endotracheal intubation for surgical, diagnostic or interventional procedures with neuromuscular blockade
Video laryngoscopy
Patients with previously classified non-difficult airway (previous easy intubation)
Patients with a previously classified difficult airway
Patients with congenital heart disease
Parental/guardian permission

You may not qualify if…

ASA ≥V
Emergency procedure
Unable to be placed in supine position for study ultrasound
Need for rapid sequence induction

Where it is running

Children's Hospital of Philadelphia — Philadelphia, Pennsylvania, United States

Full record on ClinicalTrials.gov

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