Seeing the way through – VividTrac in successful intubation of a neonate with VACTERL anomaly: a case report

Abstract

Airway management in neonates is challenging due to anatomical and physiological factors, and the presence of congenital anomalies such as VACTERL association further increases the risk of difficult intubation. We report a case of a 3-day-old late preterm male neonate weighing 2.8 kg, antenatally diagnosed with anal atresia and associated cardiac and renal anomalies, posted for high pelvic colostomy. Anticipating a difficult airway and perioperative instability, tracheal intubation was performed using the VividTrac video laryngoscope. The device provided an excellent glottic view and enabled successful first-attempt intubation with a 3.0 mm uncuffed endotracheal tube, while maintaining oxygen saturation above 95%. Anaesthesia and intraoperative hemodynamics remained stable, and the neonate was transferred postoperatively to the neonatal intensive care unit for further care. This case highlights the usefulness of VividTrac video laryngoscopy in securing the airway safely and efficiently in neonates with suspected VACTERL anomaly, emphasising its role in reducing anaesthetic complications in high-risk neonatal airways.