Rombey, Tanja ORCID: 0000-0001-5777-9738, Schieren, Mark and Pieper, Dawid (2018). Video Versus Direct Laryngoscopy for Inpatient Emergency Intubation in Adults. Dtsch. Arztebl. Int., 115 (26). S. 437 - 453. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: Emergency intubation carries a higher risk of complications than elective airway management. Video laryngoscopy (VL) could potentially improve patient safety. The goal of this study was to determine whether VL is superior to direct laryngoscopy for the emergency intubation of adults in the inpatient setting. Methods: Pertinent studies were retrieved by a systematic literature search in the MEDLINE, Embase, and CENTRAL databases. The selection of studies, data extraction, and assessment of the potential for bias were carried out independently by two of the authors. Effect sizes were reported as odds ratios (OR) or mean differences (MD). The primary endpoint was successful intubation at the first attempt. Further variables were considered as secondary endpoints. Results: 1098 titles and abstracts were retrieved, and the full texts of 43 articles were examined. Eight randomized and controlled trials, with a total of 1796 patients, were analyzed. VL was not found to confer any statistically significant advantage with respect to successful intubation at the first attempt (OR 0.72, 95% confidence interval [0.47; 1.12]) or with respect to the time to successful intubation (MD -8.99 seconds [-24.00; 6.01]). On the other hand, the use of VL was significantly associated with a lower number of intubation attempts (MD -0.17 [-0.31; -0.03]) and with a lower frequency of esophageal intubation (OR 0.27 [0.10; 0.75]). Conclusion: The routine use of VL for airway management in emergency medicine might improve patient safety, as VL is associated with a lower number of intubation attempts and with a lower frequency of esophageal intubation. Further randomized controlled trials are needed before any definitive conclusions can be drawn about the advantages of video laryngoscopy.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Rombey, TanjaUNSPECIFIEDorcid.org/0000-0001-5777-9738UNSPECIFIED
Schieren, MarkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pieper, DawidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-182477
DOI: 10.3238/arztebl.2018.0437
Journal or Publication Title: Dtsch. Arztebl. Int.
Volume: 115
Number: 26
Page Range: S. 437 - 453
Date: 2018
Publisher: DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication: COLOGNE
ISSN: 1866-0452
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CRITICALLY-ILL ADULTS; MACINTOSH LARYNGOSCOPE; ENDOTRACHEAL INTUBATION; TRACHEAL INTUBATION; C-MAC; OROTRACHEAL INTUBATION; MCGRATH(R) VIDEOLARYNGOSCOPE; SYSTEMATIC REVIEWS; RANDOMIZED-TRIAL; INTENSIVE-CAREMultiple languages
Medicine, General & InternalMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/18247

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