Video laryngoscopy versus direct laryngoscopy in achieving successful emergency endotracheal intubations: a systematic review and meta-analysis of randomized controlled trials

Intubating a patient in an emergent setting presents significant challenges compared to planned intubation in an operating room. This study aims to compare video laryngoscopy versus direct laryngoscopy in achieving successful endotracheal intubation on the first attempt in emergency intubations, irr...

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Published in:Systematic reviews 2024-03, Vol.13 (1), p.85-13, Article 85
Main Authors: Alsabri, Mohammed, Abdelwahab, Omar Ahmed, Elsnhory, Ahmed Bostamy, Diab, Rehab Adel, Sabesan, Vaishnavi, Ayyan, Muhammad, McClean, Christopher, Alhadheri, Ayman
Format: Article
Language:English
Subjects:
Bias
Cardiac arrest
Clinical trials
Direct laryngoscope
Emergent airway
Emergent intubation
Endotracheal intubation
Esophagus
First-attempt success
Humans
Hypoxia
Intubation
Intubation, Intratracheal
Laryngoscopes
Laryngoscopy
Meta-analysis
Patients
Pediatrics
Randomized Controlled Trials as Topic
Records
Software
Success
Systematic review
Trauma
Video laryngoscopy
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container_title Systematic reviews
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creator Alsabri, Mohammed
Abdelwahab, Omar Ahmed
Elsnhory, Ahmed Bostamy
Diab, Rehab Adel
Sabesan, Vaishnavi
Ayyan, Muhammad
McClean, Christopher
Alhadheri, Ayman
description Intubating a patient in an emergent setting presents significant challenges compared to planned intubation in an operating room. This study aims to compare video laryngoscopy versus direct laryngoscopy in achieving successful endotracheal intubation on the first attempt in emergency intubations, irrespective of the clinical setting. We systematically searched PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials from inception until 27 February 2023. We included only randomized controlled trials that included patients who had undergone emergent endotracheal intubation for any indication, regardless of the clinical setting. We used the Cochrane risk-of-bias assessment tool 2 (ROB2) to assess the included studies. We used the mean difference (MD) and risk ratio (RR), with the corresponding 95% confidence interval (CI), to pool the continuous and dichotomous variables, respectively. Fourteen studies were included with a total of 2470 patients. The overall analysis favored video laryngoscopy over direct laryngoscopy in first-attempt success rate (RR = 1.09, 95% CI [1.02, 1.18], P = 0.02), first-attempt intubation time (MD =  - 6.92, 95% CI [- 12.86, - 0.99], P = 0.02), intubation difficulty score (MD =  - 0.62, 95% CI [- 0.86, - 0.37], P 
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This study aims to compare video laryngoscopy versus direct laryngoscopy in achieving successful endotracheal intubation on the first attempt in emergency intubations, irrespective of the clinical setting. We systematically searched PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials from inception until 27 February 2023. We included only randomized controlled trials that included patients who had undergone emergent endotracheal intubation for any indication, regardless of the clinical setting. We used the Cochrane risk-of-bias assessment tool 2 (ROB2) to assess the included studies. We used the mean difference (MD) and risk ratio (RR), with the corresponding 95% confidence interval (CI), to pool the continuous and dichotomous variables, respectively. Fourteen studies were included with a total of 2470 patients. The overall analysis favored video laryngoscopy over direct laryngoscopy in first-attempt success rate (RR = 1.09, 95% CI [1.02, 1.18], P = 0.02), first-attempt intubation time (MD =  - 6.92, 95% CI [- 12.86, - 0.99], P = 0.02), intubation difficulty score (MD =  - 0.62, 95% CI [- 0.86, - 0.37], P &lt; 0.001), peri-intubation percentage of glottis opening (MD = 24.91, 95% CI [11.18, 38.64], P &lt; 0.001), upper airway injuries (RR = 0.15, 95% CI [0.04, 0.56], P = 0.005), and esophageal intubation (RR = 0.37, 95% CI [0.15, 0.94], P = 0.04). However, no difference between the two groups was found regarding the overall intubation success rate (P &gt; 0.05). 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subjects Bias
Cardiac arrest
Clinical trials
Direct laryngoscope
Emergent airway
Emergent intubation
Endotracheal intubation
Esophagus
First-attempt success
Humans
Hypoxia
Intubation
Intubation, Intratracheal
Laryngoscopes
Laryngoscopy
Meta-analysis
Patients
Pediatrics
Randomized Controlled Trials as Topic
Records
Software
Success
Systematic review
Trauma
Video laryngoscopy
title Video laryngoscopy versus direct laryngoscopy in achieving successful emergency endotracheal intubations: a systematic review and meta-analysis of randomized controlled trials
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