Direct Laryngoscopy Versus Video Laryngoscopy for Intubation in Critically Ill Patients: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Trials*
Pooled result · First pass success (FPS)Result — go to the resultRR for first pass success 1.13 95% CI 1.06–1.21Authors' conclusion
In critically ill adult patients undergoing intubation, the use of VL, compared with DL, probably leads to higher rates of FPS and probably decreases esophageal intubations. VL may result in fewer dental injuries as well as aspiration events compared with DL with no effect on mortality.
Study context
- Population
- Critically ill adults undergoing endotracheal intubation in the ED and ICU
- Participants
- 4,569 adults · 20 randomized controlled trials (RCTs)
- Comparison
- Video laryngoscopy vs direct laryngoscopy for intubation
- Outcome
- First pass success (FPS)
Methodological detailstrial sequential analysis, random-effects model, GRADE certainty of evidence
- Trial sequential analysis
- Random-effects model
- GRADE certainty of evidence
Pooled result
As reported in the abstract
RR for first pass success
1.13
95% CI 1.06–1.21
VL vs DL
RR for first pass success 1.13 (95% CI 1.06–1.21)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| MortalityLow certainty | 0.97 (0.88–1.07) | |
| 0.512Relative risk (log scale) |
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Esophageal intubationModerate certainty | 0.47 (0.27–0.82) | |
| Aspiration eventsLow certainty | 0.74 (0.51–1.09) | |
| Dental injuriesLow certainty | 0.46 (0.19–1.11) | |
| 0.20.5125Relative risk (log scale) |
Original publication
Direct Laryngoscopy Versus Video Laryngoscopy for Intubation in Critically Ill Patients: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Trials*. Crit Care Med. Published 18 September 2024. doi:10.
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