scholarly journals A Meta-Analysis on the Effectiveness of Video Laryngoscopy versus Laryngoscopy for Emergency Orotracheal Intubation

2022 ◽  
Vol 2022 ◽  
pp. 1-11
Author(s):  
Xiaotong Ba
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Risk Ratio ◽  
Direct Laryngoscopy ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Orotracheal Intubation ◽  
Video Laryngoscopy ◽  
Airway Trauma

Background. Video laryngoscopy has been associated with some orotracheal intubations and enhances the glottic view at time of laryngoscopy and the success rate of the intubation in patients from the emergency department and the intensive care unit. In usual cases, direct laryngoscopy is performed among the patients from the emergency department or the intensive care unit. In this systematic review and meta-analysis, we draw the comparison between the video laryngoscopy and direct laryngoscopy for the emergency orotracheal intubation. Objective. The objective of the study was to identify the clinical efficacy of video laryngoscopy versus laryngoscopy for emergency orotracheal intubation. Materials and Methods. MEDLINE, CENTRAL, EMBASE, and Web of Science databases were analyzed from 2003 to 2020. Keywords used for searching the studies were “laryngoscopy,” “video laryngoscopy,” “direct laryngoscopy,” “emergency department,” “intensive care unit,” “orotracheal,” “video laryngoscope,” “glidescope,” “airway scope,” “airway,” “Macintosh laryngoscopy,” “airway management,” “tracheal intubation,” “orotracheal intubation,” and “intubation.” Results. The first-pass intubation success rates in the intensive care unit were low in video laryngoscopy with 95% CI 1.21 (1.13–1.30) and heterogeneity I2 = 78% favoring direct laryngoscopy nonsignificantly with low heterogeneity. Odds ratio for airway trauma or dental damage was 0.67, 95% CI (0.18–2.54), reported higher in video laryngoscopy. Complications with oesophageal laryngoscopy were higher in video laryngoscopy with risk ratio 0.16, 95% CI (0.09–0.29), odds ratio 0.88, 95% CI (0.65–1.18) for sever hypoxemia, risk ratio 1.53, 95% CI (1.02–2.28) for cardiovascular collapse, risk ratio with 95% CI 1.11 (0.59–2.07) for aspiration complications, and odds ratio 1.32, 95% CI (0.95, 1.85) for Inexperienced medical staff handling laryngoscopy. Conclusion. No significant efficiency was noticed in using video laryngoscopy when compared with direct laryngoscopy with the available data. The data reported in studies are not enough for efficient clinical analysis of the benefits of using video laryngoscopy over direct laryngoscopy. Thus, information such as length of stay, mortality, sever complications, and length of hospital stay must be reported.

scholarly journals Recent advances in laryngoscopy in adults

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 797 ◽  
Author(s):  
Matteo Parotto ◽  
Richard Cooper
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Patient Safety ◽  
Intensive Care ◽  
Tracheal Intubation ◽  
Direct Laryngoscopy ◽  
Line Of Sight ◽  
Clinical Settings ◽  
Care Providers ◽  
Recent Advances

Recent advances in technology have made laryngoscopy less dependent upon a direct line of sight to achieve tracheal intubation. Whether these new devices are useful tools capable of increasing patient safety depends upon when and how they are used. We briefly consider the challenges in reviewing the emerging literature given the variety of devices, “experience” of the care providers, the clinical settings, and the definitions of outcome. We examine some of the limitations of conventional direct laryngoscopy, question the definitions we have used to define success, discuss the benefits of indirect (video) techniques, and review evidence pertaining to their use in the patients in the operating room, emergency department, and intensive care unit.

scholarly journals Predicting Prolonged Intensive Care Unit Stay Among Patients With Sepsis-Induced Hypotension

2019 ◽  
Vol 28 (6) ◽  
pp. e1-e7
Author(s):  
David L. Murphy ◽  
Nicholas J. Johnson ◽  
M. Kennedy Hall ◽  
Mitchell L. Kim ◽  
Nathan I. Shapiro ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Creatinine Level ◽  
Odds Ratio ◽  
Area Under Curve ◽  
Bicarbonate Level ◽  
Icu Stay ◽  
Emergency Department Patients

Background Sepsis risk stratification tools typically predict mortality, although stays in the intensive care unit (ICU) of 24 hours or longer may be more clinically relevant for emergency department disposition. Objective To explore predictors of ICU stay of 24 hours or longer among infected, hypotensive emergency department patients. Methods A secondary analysis of 2 prospective, observational studies of adult patients with severe sepsis or an infection with a systolic blood pressure less than 90 mm Hg in 3 urban, academic emergency departments was performed. Patients with hypotension and infection were included. Patients with emergency department intubation, vasopressor administration, and/or death were excluded. The primary outcome was ICU stay of 24 hours or longer or death in less than 24 hours. Multivariable logistic regression was used to predict ICU stay of 24 hours or longer. Results Of 233 patients, 108 (46.4%) had ICU stays of 24 hours or longer. History of heart failure (odds ratio, 3.6; 95% CI, 1.5-8.3), bicarbonate level less than 20 mEq/L (odds ratio, 2.0; 95% CI, 1.1-3.8), respiratory rate greater than 20/min (odds ratio, 2.0; 95% CI, 1.1-3.7), and creatinine level greater than 2.0 mg/dL (odds ratio, 3.6; 95% CI, 1.9-6.7) were independent predictors of ICU stay of 24 hours or longer (area under curve, 0.74). The presence of 1 of these factors predicted ICU stay of 24 hours or longer (area under curve, 0.74) with 82.4% sensitivity and 49.6% specificity. Conclusions These exploratory results show that heart failure, bicarbonate level of less than 20 mEq/L, tachypnea, or creatinine level greater than 2.0 mg/dL increases the likelihood of an ICU stay of 24 hours or longer among infected, hypotensive emergency department patients.

scholarly journals Approach to the Airway in the Emergency Department (ED) and Intensive Care Unit (ICU) in a Portuguese University Hospital Center: a prospective observational study

2019 ◽  
Author(s):  
Tiago Cabral ◽  
Helena Figueira ◽  
Ricardo Oliveira ◽  
Ângela Mota ◽  
Irene Aragão ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Statistical Analysis ◽  
Observational Study ◽  
Airway Management ◽  
Prospective Observational Study ◽  
Orotracheal Intubation ◽  
University Hospital ◽  
The University

Abstract Background Airway management is a commonly performed procedure in the Emergency Department (ED) and Intensive Care Unit (ICU), being tracheal intubation the gold standard with relatively high rates of complications in these settings. The purpose of our study was to analyse the airway approach in our institution at ED and ICU identifying the main complications associated and taking notice of possible factors related to them. Methods Prospective observational study conducted between May and September 2014 in the ICU and ED of Santo Antonio Hospital, with the primary aim of identifying the main complications of the airway approach in the critical patient and secondary aim to take notice of possible factors related with complications of the airway approach related to technical skills of the operator, patient´s specificities and airway approach techniques. The statistical analysis was done in cooperation with the Medical Informatics and Biostatistics Department of the Faculty of Medicine of the University of Porto. P values <0.05 were considered significant for all hypothesis testing. The analysis was done using the statistical analysis program SPSS® v.21.0 Results A total of 182 patients were included, corresponding to 257 attempted tracheal intubations (ATI). The rate of successful first-pass orotracheal intubation was 67%. Complications related to ATI were reported in 30% of all attempts, being most frequently among residents (81%, p=0.001) and those with little experience in airway approach (46%, p<0.001). The majority of complications was failed intubation (18%). In the group with complications, relation with an identifiable obvious cause was seen in 87% of cases (p<0.001), the major being inexperience in 42% of operators with complications, instead of 1% in the group without complications (p<0.001). Conclusions Failed ATI and its complications are largely dependent on operator´s expertise. Factors related to patient, lack of appropriate equipment and inappropriate strategy delineation also play a role. Recognition of patients at particular risk of difficult airway management is crucial.

Sign in / Sign up

Export Citation Format

Share Document