Pediatric anesthesia & critical care
Videolaryngoscopy versus direct laryngoscopy for paediatric tracheal intubation: a systematic review with meta-analysis and trial sequential analysis
Pooled result · First-attempt tracheal intubation successResult — go to the resultRR for first-attempt intubation success 1.03 95% CI 0.99–1.07Authors' conclusion
In paediatric patients with mostly normal airways, no significant differences were observed between VL and DL in achieving first-attempt tracheal intubation success.
Study context
- Population
- Paediatric patients (<16 yr) undergoing tracheal intubation
- Participants
- 4,887 patients · 53 RCTs
- Comparison
- Videolaryngoscopy (VL) vs direct laryngoscopy (DL) for paediatric tracheal intubation
- Outcome
- First-attempt tracheal intubation success rate
Methodological detailstrial sequential analysis
- Trial sequential analysis
Pooled result
First-attempt tracheal intubation success
RR for first-attempt intubation success
1.03
95% CI 0.99–1.07
P = 0.18
VL vs DL
RR for first-attempt intubation success 1.03 (95% CI 0.99–1.07); P = 0.18
As reported in the abstract
Further pooled results
| Outcome | MD (%) (95% CI) | P value | |
|---|---|---|---|
| Glottic visualisation (Percentage of Glottic Opening score), all paediatric age groups | 9.8 (3.2–16.4) | P < 0.01 | |
| −1001020Difference, % (linear scale) |
| Outcome | MD (s) (95% CI) |
|---|---|
| Intubation time | +3 (0.1–5.4) |
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Oesophageal intubation, children under 1 yr (subgroup)Low certainty of evidence | 0.16 (0.06–0.40) | P < 0.01 | |
| 0.050.21520Relative risk (log scale) |
Original publication
Videolaryngoscopy versus direct laryngoscopy for paediatric tracheal intubation: a systematic review with meta-analysis and trial sequential analysis. Br J Anaesth. Published 3 October 2025. doi:10.
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