Direct Versus Video Laryngoscopy in a Helicopter Emergency Medical Services Setting: A Retrospective Comparison

Lenz, Timothy J.; Olsen, Jens

doi:10.1016/j.amj.2021.07.008

Cited by 3 publications

(2 citation statements)

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“…15,18 However, the use of VL was not associated with greater first-pass success until the last study by Lenz, et al in 2021 was added. 14 For sensitivity analysis, after each individual study was removed from the meta-analysis, the risk ratio for first-pass success rate remained between 1.042 and 1.156 (Figure 3C), which was well within the 95% CI for the study's 95% CI. This result suggested that effect size was not overly influenced by any individual study.…”

Section: Study Descriptionmentioning

confidence: 55%

“…Two were randomized control trials (2013 Guyette, 2017 Ducharme), one was a prospective study (2020 Garcia-Pintos), and four were retrospective studies (2015 Jarvis, 2018 Louka, 2021 Huebinger, 2021 Lenz). [14][15][16][17][18][19][20] Three studies enrolled fewer than 100 patients (2017 Ducharme, 2018 Louka, 2020 Garcia-Pintos), while the 2021 Huebinger study involved a large population (22,132 patients). [15][16][17]20 In all the studies, a total of 6,674 patients underwent intubation via VL and 17,279 patients underwent DL (Table 1).…”

Section: Study Descriptionmentioning

confidence: 99%

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Efficacy of Video Laryngoscopy versus Direct Laryngoscopy in the Prehospital Setting: A Systematic Review and Meta-Analysis

Pourmand

Terrebonne

Gerber

et al. 2022

Prehosp. Disaster med.

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Introduction: Placing an endotracheal tube is a life-saving measure. Direct laryngoscopy (DL) is traditionally the default method. Video laryngoscopy (VL) has been shown to improve efficiency, but there is insufficient evidence comparing VL versus DL in the prehospital settings. This study, comprising a systematic review and random-effects meta-analysis, assesses current literature for the efficacy of VL in prehospital settings. Methods: PubMed and Scopus databases were searched from their beginnings through March 1, 2022 for eligible studies. Outcomes were the ﬁrst successful intubation, overall success rate, and number of total DL versus VL attempts in real-life clinical situations. Cochrane’s Risk of Bias (RoB) tool and the Newcastle-Ottawa Scale (NOS) were applied to assess risk of bias and study quality; Q-statistics and I2 values were used to assess heterogeneity. Results: The search yielded seven studies involving 23,953 patients, 6,674 (28%) of whom underwent intubation via VL. Compared to DL, VL was associated with a statistically higher risk ratio for first-pass success (Risk Ratio [RR] = 1.116; 95% CI, 1.005-1.239; P = .041; I2 = 87%). The I2 value for the subgroup of prospective studies was 0% compared to 89% for retrospective studies. In addition, VL was associated with higher likelihood of overall success rate (RR = 1.097; 95% CI, 1.01-1.18; P = .021; I2 = 85%) and lower mean number of attempts (Mean Difference = -0.529; 95% CI, -0.922 to -0.137; P = .008). Conclusion: The meta-analysis suggested that VL was associated with higher likelihood of achieving first-pass success, greater overall success rate, and lower number of intubation attempts for adults in the prehospital settings. This study had high heterogeneity, likely presenced by the inclusion of retrospective observational studies. Further studies with more rigorous methodology are needed to confirm these results.

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Section: Study Descriptionmentioning

confidence: 55%