Video Versus Direct Laryngoscopy for Inpatient Emergency Intubation in Adults

Rombey, Tanja; Schieren, Mark; Pieper, Dawid

doi:10.3238/arztebl.2018.0437

Cited by 12 publications

(10 citation statements)

References 48 publications

(42 reference statements)

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“…We excluded four meta-analyses involving the Miller blade from our systematic review. 11 , 15 , 19 , 21 Of note, three of these four were pediatric studies, 11 , 15 , 19 highlighting the heterogeneity related to Macintosh and Miller blades in the pediatric airway literature. As a straight blade, Miller blade DL is generally different from the Mac-DL technique.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review of meta-analyses comparing direct laryngoscopy with videolaryngoscopy

Downey

Duggan

Law

2021

Can J Anesth/J Can Anesth

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In the preceding 20 years, many randomizedcontrolled trials and meta-analyses have compared direct Macintosh laryngoscopy with videolaryngoscopy. The videolaryngoscope blades have included both traditional Macintosh blades and hyperangulated blades. Macintosh and hyperangulated blades differ in their geometry and technique for tracheal intubation; certain patient populations may benefit from one blade type over another. The primary objective of this systematic review was to assess whether published meta-analyses comparing direct Macintosh laryngoscopy to videolaryngoscopy have accounted for the videolaryngoscope blade type. Secondary objectives evaluated heterogeneity among practitioner experience and specialty, clinical context, patient population, and original primary study outcomes. Source A search was performed across Ovid Medline, Ovid Embase, ClinicalKey, PubMed, TRIP, AccessAnesthesiology, Google Scholar, and ANZCA discovery. A systematic review identified meta-analyses which compared direct Macintosh laryngoscopy to videolaryngoscopy. There were no patient age or clinical specialty restrictions. Exclusion criteria included non-

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Section: Discussionmentioning

confidence: 99%

“…Literature comparing VL to Mac-DL often describes an improved glottic view, 7 - 16 and either the same or improved tracheal intubation success with VL. 7 - 12 , 14 , 16 - 29 Additionally, several studies describe fewer complications with VL, including fewer esophageal intubations 14 , 21 , 26 , 30 and glottic trauma. 12 , 20 , 27 …”

mentioning

confidence: 99%

A systematic review of meta-analyses comparing direct laryngoscopy with videolaryngoscopy

Downey

Duggan

Law

2021

Can J Anesth/J Can Anesth

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“…Several studies have demonstrated a higher success rate for novices with fewer complications for VL compared with DL, particularly outside of the OR [ [70] , [71] , [72] , [73] , [74] ]. This finding, however, is not consistent between studies and may be affected by the device, environment, and operator factors [ [75] , [76] , [77] ]. Additionally, it also has been suggested that novice trainees may have more rapid acquisition of DL skills when VL is practiced first with video-assisted instruction [ 78 , 79 ], although, again, this is not a consistent observation [ 80 ].…”

Section: Do You Need To Teach Direct Laryngoscopy Video Laryngoscopymentioning

confidence: 79%

“…Excessive emphasis on DL or VL using hyperangulated blades may not provide the best support for future clinical responsibilities. From a clinical perspective, the use of VL is linked to a higher success rate in this population with fewer esophageal intubations [ 77 ].…”

Section: Do You Need To Teach Direct Laryngoscopy Video Laryngoscopymentioning

confidence: 99%

The Anesthesiologist’s Role in Teaching Airway Management to Nonanesthesiologists

Grissom

Samet

2020

Advances in Anesthesia

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“…However, a randomised trial in intensive care units (ICUs) showed no difference in first-pass intubation success rates between VLs and the Macintosh system 11. A systematic review of emergency TIs in emergency departments (EDs) and ICUs showed that the use of VLs had no significant advantage with regard to first-attempt success rates, although their use was significantly associated with a lower number of intubation attempts 12. However, these studies included various types of VL in a single group and did not consider the characteristics of each VL.…”

Section: Introductionmentioning

confidence: 99%

Comparison of three video laryngoscopes and direct laryngoscopy for emergency endotracheal intubation: a retrospective cohort study

et al. 2019

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ObjectiveVideo laryngoscopes are used for managing difficult airways. This study compared three video laryngoscopes’ (Pentax-Airway Scope [Pentax], King Vision[King] and McGrath MAC [McGrath]) performances with the Macintosh direct laryngoscope (Macintosh) as emergency tracheal intubations (TIs) reference.DesignRetrospective cohort study.SettingThe emergency department (ED) and the intensive care unit (ICU) of two Japanese tertiary-level hospitals.ParticipantsAll consecutive video-recorded emergency TI cases in EDs and ICUs between December 2013 and June 2015.Primary outcome measuresThe primary study endpoint was first-pass intubation success. A subgroup analysis examined the first-pass intubation success of expert versus non-expert operators. A logistic regression analysis was performed to identify the predictors of first-pass intubation success.ResultsA total of 287 emergency TIs were included. The first-pass intubation success rates were 78%, 58%, 78% and 58% for the Pentax, King, McGrath and Macintosh instruments, respectively (p=0.004, Fisher’s exact test). The non-expert operators’ success rates were significantly higher (p=0.00004, Fisher’s exact test) for the Pentax (87%) and McGrath (78%) instruments than that for the King (50%) and Macintosh (46%) instruments, unlike that of the experts (67%, 67%, 78% and 78% for Pentax, McGrath, King and Macintosh, respectively; p=0.556, Fisher’s exact test). After TI indication, difficult airway characteristics, and expert versus non-expert operator parameters adjustments, the Pentax (OR=3.422, 95% CI 1.551 to 7.550; p=0.002) and McGrath (OR= 3.758, CI 1.640 to 8.612; p=0.002) instruments showed significantly higher first-pass intubation success odds when compared with the Macintosh laryngoscope (reference, OR=1). The King instrument, however, (OR=1.056; 95% CI 0.487 to 2.289, p=0.889) failed to show any significant superiority.ConclusionThe Pentax and McGrath laryngoscopes showed significantly higher emergency TI first-pass intubation success rates than the King laryngoscope when compared with the Macintosh laryngoscope, especially for non-expert operators.Trial registration numberUMIN000027925; Results.

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Video Versus Direct Laryngoscopy for Inpatient Emergency Intubation in Adults

Cited by 12 publications

References 48 publications

A systematic review of meta-analyses comparing direct laryngoscopy with videolaryngoscopy

A systematic review of meta-analyses comparing direct laryngoscopy with videolaryngoscopy

The Anesthesiologist’s Role in Teaching Airway Management to Nonanesthesiologists

Comparison of three video laryngoscopes and direct laryngoscopy for emergency endotracheal intubation: a retrospective cohort study

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