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. 2018;9(2):99-104.
doi: 10.5847/wjem.j.1920-8642.2018.02.003.

Video versus direct laryngoscopy on successful first-pass endotracheal intubation in ICU patients

Yong-Xia Gao  1 , Yan-Bo Song  1 , Ze-Juan Gu  1 , Jin-Song Zhang  1 , Xu-Feng Chen  1 , Hao Sun  1 , Zhen Lu  1
Affiliations

Video versus direct laryngoscopy on successful first-pass endotracheal intubation in ICU patients

Yong-Xia Gao et al. World J Emerg Med. 2018.

Abstract

Background: Airway management in intensive care unit (ICU) patients is challenging. The aim of this study was to compare the rate of successful first-pass intubation in the ICU by using the direct laryngoscopy (DL) and that by using the video laryngoscopy (VL).

Methods: A randomized, non-blinded trial comparing first-pass success rate of intubation between VL and DL was performed. Patients were recruited in the period from August 2014 to August 2016. All physicians working at ICU received hands-on training in the use of the video and direct laryngoscope. The primary outcome measure was the first-pass intubation success.

Results: A total of 163 ICU patients underwent intubation during the study period (81 patients in VL group and 82 in DL group). The rate of successful first-pass intubation was not significantly different between the VL and the DL group (67.9% vs. 69.5%, P=0.824). Moreover, the overall intubation success and total number of attempts to achieve intubation success did not differ between the two groups. In patients with successful first-pass intubation, the median duration of the intubation procedure did not differ between the two groups. The Cormack-Lehane grades and the percentage of glottic opening score were similar, and no significant differences were found between the two groups. There were no statistical differences between the VL and the DL group in intubation complications (all P>0.05).

Conclusion: Among ICU patients requiring intubation, there was no significant difference in the rate of successful first-pass intubation between VL and DL.

Keywords: Direct laryngoscopy; Intensive care unit; Intubation; Video laryngoscopy.

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Conflict of interest statement

Conflicts of interest: There is no conflict of interest related to this study.

Figures

Figure 1
Figure 1
Flow of patients through the video laryngoscopy versus direct laryngoscopy for endotracheal intubation in ICU patients.
See this image and copyright information in PMC

References

    1. De Jong A, Molinari N, Conseil M, Coisel Y, Pouzeratte Y, Belafia F, et al. Video laryngoscopy versus direct laryngoscopy for endotracheal intubation in the intensive care unit: a systematic review and meta-analysis. Intensive Care Med. 2014;40(5):629–39. - PubMed
    1. Jaber S, Amraoui J, Lefrant JY, Arich C, Cohendy R, Landreau L, et al. Clinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Crit Care Med. 2006;34(9):2355–61. - PubMed
    1. Mosier JM, Sakles JC, Stolz U, Hypes CD, Chopra H, Malo J, et al. Neuromuscular blockade improves first-attempt success for intubation in the intensive care unit. A propensity matched analysis. Ann Am Thorac Soc. 2015;12(5):734–41. - PMC - PubMed
    1. Griesdale DE, Bosma TL, Kurth T, Isac G, Chittock DR. Complications of endotracheal intubation in the critically ill. Intensive Care Med. 2008;34(10):1835–42. - PubMed
    1. Campbell SG, Magee KD, Zed PJ, Froese P, Etsell G, LaPierre A, et al. End-tidal capnometry during emergency department procedural sedation and analgesia: a randomized, controlled study. World J Emerg Med. 2016;7(1):13–8. - PMC - PubMed

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