A comparison of paediatric airway anatomy with the SimBaby high-fidelity patient simulator

BackgroundThe SimBaby high-fidelity patient simulator is a widely used paediatric simulator for the training of standard and critical airway management scenarios. Furthermore this simulator is frequently used for the evaluation of different airway devices and techniques. However, the anatomic structures of the SimBaby have not been compared to actual patients’ anatomy.MethodsThe CT radiographic measures of the upper airway anatomy of two SimBaby simulators were compared to MRI images of the upper airway of 20 children aged 1–11 months who underwent routine MRI scans under sedation for diagnostic purposes. Various distances of the tongue, soft palate and pharynx, cross sectional areas and volumes of anatomic structures of the upper airway including the retroglossal airspace were compared.ResultsThe SimBaby's retroglossal airspace volume greatly differed from the measurements in patients (SimBaby 5.3 ± 0.4 vs. 1.9 ± 0.8 cm3 in infants, p < 0.01). Furthermore the distance from the alveolar process of the mandible to the posterior pharyngeal wall was larger in the SimBaby than in infants (5.8 ± 0.1 vs. 4.5 ± 0.5 cm, p < 0.001) and dimensions of the epiglottis and pharynx were larger in the Simbaby.ConclusionThe anatomic features of the SimBaby do not adequately simulate the upper airway anatomy of infants. These results imply inadequate realism of this simulator for airway training and compromise the validity of comparative trials of different airway devices with the SimBaby as airway model.