Successful Intubation on First Attempt Improved With Video Laryngoscopy

WEDNESDAY, June 21, 2023 (HealthDay News) -- The use of video laryngoscopy results in a higher incidence of successful intubation on the first attempt among critically ill adults undergoing tracheal intubation in an emergency department or intensive care unit, according to a study published online June 16 in the New England Journal of Medicine to coincide with the annual Critical Care Reviews Meeting, held from June 14 to 16 in Belfast, Northern Ireland.

Matthew E. Prekker, M.D., M.P.H., from the Hennepin County Medical Center in Minneapolis, and colleagues conducted a multicenter, randomized trial at 17 emergency departments and intensive care units involving critically ill adults undergoing tracheal intubation. Participants were randomly assigned to the video-laryngoscope group or the direct-laryngoscope group (705 and 712 patients, respectively, were included in the final analysis).

At the time of the single preplanned interim analysis, the trial was stopped for efficacy. The researchers found that successful intubation on the first attempt occurred in 85.1 percent of patients in the video-laryngoscope group and 70.8 percent in the direct-laryngoscope group. Overall, 21.4 and 20.9 percent of those in the video-laryngoscope and direct-laryngoscope groups, respectively, had a severe complication during intubation. The two groups had similar safety outcomes, including esophageal intubation, injury to the teeth, and aspiration.

"In our trial, the use of a video laryngoscope appeared to increase the likelihood of successful intubation on the first attempt for operators at all levels of experience, but the between-group difference in the primary outcome appeared to be greatest among the least experienced operators," the authors write.

Several authors disclosed financial ties to industry.

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