Safety and effectiveness of endotracheal intubation in critically ill emergency patients with videolaryngoscopy

Abstract

To investigate the safety and efficacy of video laryngoscopy for endotracheal intubation in critically ill patients. A total of 106 critically ill emergency patients treated at our hospital between January 2021 and June 2022 were randomly divided into 2 groups, the visual and direct groups, with 53 patients in each group. Both groups were treated with endotracheal intubation; the visual group was treated with video laryngoscopy, and the direct group was treated with conventional direct laryngoscopy. The Cormack–Lehane grade, percentage of glottic opening score, success rate of one intubation, intubation time, number of intubation attempts, hemodynamic values, and complications were compared between the 2 groups. The success rates of glottis exposure and one-time intubation were significantly higher while the intubation time and number of intubation attempts significantly lower in the visual group than in the direct group. The heart rate, mean arterial pressure (MAP), or blood oxygen saturation did not differ significantly between the 2 groups 10 minutes after entering the room (T0) or after anesthesia induction (T1). MAP was significantly lower in the visual group than in the direct group during immediate intubation (T2). The heart rate and MAP were significantly lower in the visual group than in the direct group 1 minute (T3) and 5 minutes (T4) after intubation. The incidences of intubation-related complications in the visual and direct groups were 7.55% and 22.60%, showing a significant difference. Endotracheal intubation under videolaryngoscopy is safer and more effective for critically ill emergency patients than conventional direct laryngoscopy. This can improve the success rate of intubation, reduce the intubation time, and reduce its effect on hemodynamics. Therefore, it is worthy of further clinical application.

A comparison of video laryngoscopy and direct laryngoscopy in critically ill patients

“…Following the authors' search strategy, our reevaluation revealed that the study omitted several randomized controlled trials (RCTs) that met the criteria, including Mo et al [ 2 ], Shukla et al [ 3 ], Ilbagi et al [ 4 ], Grensemann et al [ 5 ], Kim et al [ 6 ], Silverberg et al [ 7 ]. These six additional RCTs increased the total patient count to 4532, with 2276 in the video laryngoscopy (VL) group and 2256 in the direct laryngoscopy (DL) group.…”