Objective: To evaluate the effect of video laryngoscopy on the rate of endotracheal intubation on first laryngoscopy attempt among critically ill adults.
Design: A randomized, parallel-group, pragmatic trial of video compared with direct laryngoscopy for 150 adults undergoing endotracheal intubation by Pulmonary and Critical Care Medicine fellows.
Setting: Medical ICU in a tertiary, academic medical center.
Patients: Critically ill patients 18 years old or older.
Interventions: Patients were randomized 1:1 to video or direct laryngoscopy for the first attempt at endotracheal intubation.
Measurements And Main Results: Patients assigned to video (n = 74) and direct (n = 76) laryngoscopy were similar at baseline. Despite better glottic visualization with video laryngoscopy, there was no difference in the primary outcome of intubation on the first laryngoscopy attempt (video 68.9% vs direct 65.8%; p = 0.68) in unadjusted analyses or after adjustment for the operator's previous experience with the assigned device (odds ratio for video laryngoscopy on intubation on first attempt 2.02; 95% CI, 0.82-5.02, p = 0.12). Secondary outcomes of time to intubation, lowest arterial oxygen saturation, complications, and in-hospital mortality were not different between video and direct laryngoscopy.
Conclusions: In critically ill adults undergoing endotracheal intubation, video laryngoscopy improves glottic visualization but does not appear to increase procedural success or decrease complications.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5203695 | PMC |
| http://dx.doi.org/10.1097/CCM.0000000000001841 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Prone Position Video Laryngoscopy for the Successful Intubation of Penetrating Back Injury: A Report of Two Cases.
Cureus
December 2024
Anesthesiology, All India Institute of Medical Sciences, New Delhi, IND.
Airway management in the prone position presents significant challenges and carries the risk of encountering a difficult airway situation. Here, we present two adults who sustained traumatic knife injuries to the back and required surgical intervention. Due to the potential life-threatening complications associated with dislodging the knife, traditional supine and lateral decubitus positions were not feasible for airway management.
View Article and Find Full Text PDFVideo analysis of neonatal intubations using video laryngoscopy: a prospective comparison of clinical practice with resuscitation guidelines.
Arch Dis Child Fetal Neonatal Ed
January 2025
Department of Neonatology, The National Maternity Hospital, Dublin, Ireland.
Background: The Neonatal Resuscitation Program recommends direct laryngoscopy (DL) as the primary method for neonatal intubation. Video laryngoscopy (VL) is suggested as an option, particularly for training novice operators or for intubating infants with difficult airways. The programme outlines specific steps for intubation, including managing the external environment and techniques for visualising key anatomical landmarks.
View Article and Find Full Text PDFVideo versus Direct Laryngoscopy for Tracheal Intubation Following Cardiac Arrest: a Secondary Analysis of the DEVICE Trial.
Chest
January 2025
Division of Pulmonary & Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.
Background: Airway management is a critical component of the care of patients experiencing cardiac arrest, but data from randomized trials on the use of video vs direct laryngoscopy for intubation in the setting of cardiac arrest are limited. Current AHA guidelines recommend placement of an endotracheal tube either during CPR or shortly after return of spontaneous circulation but do not provide guidance around intubation methods, including the choice of laryngoscope.
Research Question: Does use of video laryngoscopy improve the incidence of successful intubation on the first attempt, compared to use of direct laryngoscopy, among adults undergoing tracheal intubation after experiencing cardiac arrest?
Study Design And Methods: This secondary analysis of the Direct versus Video Laryngoscope (DEVICE) trial compared video laryngoscopy versus direct laryngoscopy in the subgroup of patients who were intubated following cardiac arrest.
McGrath MAC Versus Three-Dimensional Printed Video Laryngoscopes: A Randomized, Manikin-Simulated Noninferiority Controlled Study with Medical Students.
Anesth Analg
February 2025
From the Department of Surgical Specialties and Anesthesiology of São Paulo State University (UNESP), Medical School, Botucatu, Brazil.
Background: Proficiency in endotracheal intubation (ETI) is essential for medical professionals and its training should start at medical schools; however, large caseload may be required before achieving an acceptable success rate with direct laryngoscopy. Video laryngoscopy has proven to be an easier alternative for intubation with a faster learning curve, but its availability in medical training may be an issue due to its high market prices. We devised a low-cost 3-dimensionally printed video laryngoscope (3DVL) and performed a randomized trial to evaluate if the intubation success rate on the first attempt with this device is noninferior to a standard commercially available video laryngoscope (STVL).
View Article and Find Full Text PDFIntubation Practices in Community Emergency Departments.
Ann Emerg Med
January 2025
Department of Emergency Medicine, Kaiser Permanente San Diego Medical Center, San Diego, CA.
Study Objective: This study analyzes emergency medicine airway management trends and outcomes among community emergency departments.
Methods: A multicenter, retrospective chart review was conducted on 11,475 intubations from 15 different community emergency departments between January 1, 2015, and December 31, 2022. Data collected included patient's age, sex, rapid sequence intubation medications, use of cricoid pressure, method of intubation, number of attempts, admission diagnosis, and all-cause mortality rates.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!