A Comparison of Video Laryngoscopy to Direct Laryngoscopy for the Emergency Intubation of Trauma Patients

Michailidou, Maria; OʼKeeffe, Terence; Mosier, Jarrod; Friese, Randall S.; Joseph, Bellal; Rhee, Peter; Sakles, John C.

doi:10.1007/s00268-014-2845-z

Cited by 62 publications

(48 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Multiple studies have noted a better view of the glottis with the video laryngoscope, but this improved view was not always associated with successful intubation in all patients 2 . The reason for this may be the time elapsed during eye and hand coordination, and manipulation of the ET tube into the trachea with the video laryngoscope may have balanced out with trying to find a proper glottic exposure with the DL.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the C-MAC video laryngoscope to the Macintosh laryngoscope for intubation of blunt trauma patients in the ED

Göksu

Kilic

Yildiz

et al. 2016

Turkish Journal of Emergency Medicine

View full text Add to dashboard Cite

ObjectivesWe aimed to compare the performance of the C-MAC video laryngoscope (C-MAC) to the Macintosh laryngoscope for intubation of blunt trauma patients in the ED.Material and methodsThis was a prospective randomized study. The primary outcome measure is overall successful intubation. Secondary outcome measures are first attempt successful intubation, Cormack–Lehane (CL) grade, and indicators of the reasons for unsuccessful intubation at the first attempt with each device. Adult patients who suffered from blunt trauma and required intubation were randomized to video laryngoscopy with C-MAC device or direct laryngoscopy (DL).ResultsDuring a 17-month period, a total of 150 trauma intubations were performed using a C-MAC and DL. Baseline characteristics of patients were similar between the C-MAC and DL group. Overall success for the C-MAC was 69/75 (92%, 95% CI 0.83 to 0.96) while for the DL it was 72/75 (96%, 95% CI 0.88 to 0.98). First attempt success for the C-MAC was 47/75 (62.7%, 95% CI 0.51 to 0.72) while for the DL it was 44/75 patients (58.7%, 95% CI 0.47 to 0.69). The mean time to achieve successful intubation was 33.4 ± 2.5 s for the C-MAC versus 42.4 ± 5.1 s for the DL (p = 0.93). There was a statistically significant difference between the DL and C-MAC in terms of visualizing the glottic opening and esophageal intubation in favor of the C-MAC (p = 0.002 and p = 0.013 respectively).Discussion and conclusionThe overall success rates were similar. The C-MAC demonstrated improved glottic view and decrease in esophageal intubation rate.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of the C-MAC video laryngoscope to the Macintosh laryngoscope for intubation of blunt trauma patients in the ED

Göksu

Kilic

Yildiz

et al. 2016

Turkish Journal of Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…Prior studies limited to non-critically ill populations (17) may not apply to the patient, operator, and procedural conditions surrounding intubation in the ICU. Un-blinded observational study designs (3, 18, 27, 28), non-random patient assignments (15), and “before-after” quality improvement studies (26) may suffer from confounding by selection bias, changes in practice over time, and the observer bias associated with self-reported data. Observer bias is of particular concern in studies reporting unexpectedly high rates of intubation failures with direct laryngoscopy compared with video laryngoscopy (15, 18, 21, 26).…”

Section: Discussionmentioning

confidence: 99%

“…Observer bias is of particular concern in studies reporting unexpectedly high rates of intubation failures with direct laryngoscopy compared with video laryngoscopy (15, 18, 21, 26). A lack of accounting of the experience of the operator at the time of the procedure (15, 16, 18, 26, 28) may also confound the results of prior work. Neuromuscular blockade, which is associated with improved glottic view and reduced intubation attempts with DL (8, 29, 30), was used in 96% of intubations in the current trial but less frequently (18, 26, 28) or not at all (15) in past studies.…”

Section: Discussionmentioning

confidence: 99%

Randomized Trial of Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults*

Janz

Semler

Lentz

et al. 2016

Critical Care Medicine

104

View full text Add to dashboard Cite

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 intensive care unit in a tertiary, academic medical center. Patients Critically ill patients ≥ 18 years old. 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% versus 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. Trial Registration clinicaltrials.gov Identifier: NCT02051816

show abstract

“…Video laryngoscopy is purported as the new criterion standard for airway management and intubation of trauma patients, and this standard is being adopted by many emergency departments [1]. Video laryngoscopy is recommended as the primary intubating device for adult patients with predicted difficult airways in the emergency department [2].…”

mentioning

confidence: 99%

Failed airway management with the GlideScope: it is not the same tool in infants

Muldowney

Stephenson

Volz

et al. 2015

Journal of Clinical Anesthesia

View full text Add to dashboard Cite

A Comparison of Video Laryngoscopy to Direct Laryngoscopy for the Emergency Intubation of Trauma Patients

Abstract: In trauma patients intubated emergently, VL had a significantly higher success rate than DL. These data suggest that, in select circumstances, VL is superior to DL for the intubation of trauma patients with difficult airways.

Cited by 62 publications

References 46 publications

Comparison of the C-MAC video laryngoscope to the Macintosh laryngoscope for intubation of blunt trauma patients in the ED

Comparison of the C-MAC video laryngoscope to the Macintosh laryngoscope for intubation of blunt trauma patients in the ED

Randomized Trial of Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults*

Failed airway management with the GlideScope: it is not the same tool in infants

Contact Info

Product

Resources

About