Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults
Primary resultResult — go to the resultAbsolute risk difference 14.3 percentage points 95% CI 9.9–18.7- stopped for efficacy
- Trial stopped for efficacy at the single preplanned interim analysis
Authors' conclusion
Among critically ill adults undergoing tracheal intubation in an emergency department or ICU, the use of a video laryngoscope resulted in a higher incidence of successful intubation on the first attempt than the use of a direct laryngoscope.
Study context
- Population
- Critically ill adults undergoing tracheal intubation at 17 EDs and intensive care units (ICUs)included in final analysis
- Participants
- 1,417 adults
- Comparison
- Video vs direct laryngoscopy for tracheal intubation
- Video laryngoscopen = 705
- Direct laryngoscopen = 712reference
- Primary endpoint
- Successful intubation on the first attempt
Methodological detailsmulticentre, preplanned interim analysis, 91.5% of intubations performed by an emergency medicine resident or critical care fellow
- Multicentre
- Preplanned interim analysis
- 91.5% of intubations performed by an emergency medicine resident or critical care fellow
Primary result
As reported in the abstract
Absolute risk difference
14.3 percentage points
95% CI 9.9–18.7
P < 0.001
Events by treatment group
Video laryngoscope vs Direct laryngoscope
absolute risk difference 14.3 percentage points (95% CI 9.9–18.7); P < 0.001
Safety
| Outcome | Video laryngoscope | Direct laryngoscope | Absolute risk difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| Severe complications during intubation (severe hypoxemia, severe hypotension, new or increased vasopressor use, cardiac arrest, or death)Secondary outcome | 21.4% | 20.9% | 0.5 (−3.9 to 4.9) | |
| −4−20246Difference, percentage points (linear scale) |
Safety outcomes incl. esophageal intubation, injury to the teeth, aspiration
- Similar in the two groups
Original publication
Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. N Engl J Med. Published 16 June 2023. doi:10.
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