Laryngoscopy and Tracheal Intubation: Does Use of a Video Laryngoscope Facilitate Both Steps of the Procedure?

被引：4

作者：

Prekker, Matthew E. ^{[1
,2
]}

Trent, Stacy A. ^{[3
]}

Lofrano, Arianna ^{[2
]}

Russell, Derek W. ^{[4
,5
]}

Barnes, Christopher R. ^{[6
]}

Brewer, Joseph M. ^{[7
]}

Doerschug, Kevin C. ^{[8
]}

Gaillard, John P. ^{[9
,10
]}

Gandotra, Sheetal ^{[12
]}

Ginde, Adit A. ^{[11
]}

Ghamande, Shekhar

Gibbs, Kevin W. ^{[13
]}

Hughes, Christopher G. ^{[14
]}

Janz, David R. ^{[15
,16
]}

Khan, Akram ^{[17
]}

Mitchell, Steven H. ^{[18
]}

Page, David B.

Rice, Todd W. ^{[19
]}

Self, Wesley H. ^{[20
]}

Smith, Lane M. ^{[21
]}

Stempek, Susan B. ^{[22
]}

Vonderhaar, Derek J. ^{[23
]}

West, Jason R. ^{[24
]}

Whitson, Micah R. ^{[25
]}

Casey, Jonathan D. ^{[19
]}

Semler, Matthew W.

Driver, Brian E.

机构：

[1] Hennepin Cty Med Ctr, Dept Emergency Med, Minneapolis, MN 55415 USA

[2] Hennepin Cty Med Ctr, Div Pulm Allergy & Crit Care Med, Minneapolis, MN USA

[3] Denver Hlth, Dept Emergency Med, Denver, CO USA

[4] Univ Alabama Birmingham, Dept Med, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA

[5] Birmingham Vet Affairs Med Ctr, Pulm Sect, Birmingham, AL USA

[6] Univ Washington, Dept Anesthesiol & Crit Care Med, Harborview Med Ctr, Seattle, WA USA

[7] Univ Mississippi Med Ctr, Dept Med, Div Pulm Crit Care & Sleep Med, Jackson, MS USA

[8] Univ Iowa Hosp & Clin, Dept Internal Med, Div Pulm Crit Care & Occupat Med, Iowa City, IA USA

[9] Atrium Hlth Wake Forest Baptist, Dept Anesthesiol, Sect Crit Care, Winston Salem, NC USA

[10] Atrium Hlth Wake Forest Baptist, Dept Emergency Med, Winston Salem, NC USA

[11] Univ Colorado, Sch Med, Dept Emergency Med, Aurora, CO USA

[12] Baylor Scott & White Hlth, Dept Med, Div Pulm Dis Crit Care & Sleep Med, Temple, TX USA

[13] Wake Forest Sch Med, Sect Pulm Crit Care Allergy & Immunol, Winston Salem, NC USA

[14] Vanderbilt Univ, Dept Anesthesiol, Div Anesthesia Crit Care Med, Med Ctr, Nashville, TN USA

[15] Louisiana State Univ, Univ Med Ctr New Orleans, Sch Med, New Orleans, LA USA

[16] Louisiana State Univ, Dept Med, Sect Pulm Crit Care Med & Allergy Immunol, Sch Med, New Orleans, LA USA

[17] Oregon Hlth & Sci Univ, Dept Med, Div Pulm & Crit Care Med, Sch Med, Portland, OR USA

[18] Univ Washington, Dept Emergency Med, Harborview Med Ctr, Seattle, WA USA

[19] Vanderbilt Univ, Dept Med, Div Pulm Allergy & Crit Care Med, Med Ctr, Nashville, TN USA

[20] Vanderbilt Univ, Dept Emergency Med, Med Ctr, Nashville, TN USA

[21] Atrium Carolinas Med Ctr, Pulm & Crit Care Associates, Charlotte, NC USA

[22] Lahey Hosp & Med Ctr, Dept Med, Div Pulm & Crit Care Med, Burlington, MA USA

[23] Ochsner Hlth, Dept Pulm & Crit Care Med, New Orleans, LA USA

[24] Lincoln Med Ctr, Dept Emergency Med, New York, NY USA

[25] Univ Alabama Birmingham, Dept Emergency Med, Birmingham, AL USA

来源：

ANNALS OF EMERGENCY MEDICINE | 2023年 / 82卷 / 04期

基金：

美国国家卫生研究院;

关键词：

D O I：

10.1016/j.annemergmed.2023.02.016

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: To compare the effect of the use of a video laryngoscope versus a direct laryngoscope on each step of emergency intubation: laryngoscopy (step 1) and intubation of the trachea (step 2). Methods: In a secondary observational analysis of data from 2 multicenter, randomized trials that enrolled critically ill adults undergoing tracheal intubation but did not control for laryngoscope type (video laryngoscope vs direct laryngoscope), we fit mixed-effects logistic regression models examining the 1) the association between laryngoscope type (video laryngoscope vs direct laryngoscope) and the Cormack-Lehane grade of view and 2) the interaction between grade of view, laryngoscope type (video laryngoscope vs direct laryngoscope), and the incidence of successful intubation on the first attempt. Results: We analyzed 1,786 patients: 467 (26.2%) in the direct laryngoscope group and 1,319 (73.9%) in the video laryngoscope group. The use of a video laryngoscope was associated with an improved grade of view as compared with a direct laryngoscope (adjusted odds ratio for increasingly favorable grade of view 3.14, 95% confidence interval [CI] 2.47 to 3.99). Successful intubation on the first attempt occurred in 83.2% of patients in the video laryngoscope group and 72.2% of patients in the direct laryngoscope group (absolute difference 11.1%, 95% CI 6.5% to 15.6%). Video laryngoscope use modified the association between grade of view and successful intubation on the first attempt such that intubation on the first attempt was similar between video laryngoscope and direct laryngoscope at a grade 1 view and higher for video laryngoscope than direct laryngoscope at grade 2 to 4 views (P<.001 for interaction term). Conclusions: Among critically ill adults undergoing tracheal intubation, the use of a video laryngoscope was associated both with a better view of the vocal cords and with a higher probability of successfully intubating the trachea when the view of the vocal cords was incomplete in this observational analysis. However, a multicenter, randomized trial directly comparing the effect of a video laryngoscope with a direct laryngoscope on the grade of view, success, and complications is needed.

引用

页码：425 / 431

页数：7

共 50 条

[1] Laryngoscopy and Tracheal Intubation: Does Use of a Video Laryngoscope Facilitate Both Steps of the Procedure?
Lofrano, A.
Prekker, M. E.
Trent, S.
Russell, D. W.
Barnes, C.
Brewer, J. M.
Doerschug, K. C.
Gaillard, J.
Gandotra, S.
Ginde, A.
Ghamande, S.
Gibbs, K.
Hughes, C. G.
Janz, D. R.
Khan, A.
Mitchell, S.
Page, D. B.
Rice, T. W.
Self, W.
Smith, L. M.
Stempek, S.
Vonderhaar, D. J.
West, J. R.
Whitson, M. R.
Casey, J. D.
Semler, M. W.
Driver, B.
[J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2023, 207
[2] The use of the BERCI DCI® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation
Low, D.
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[J]. ANAESTHESIA, 2008, 63 (02) : 195 - 201
[3] Use of a tracheal tube introducer guide to facilitate difficult intubation with a video laryngoscope
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[4] Use of a tracheal tube introducer guide to facilitate difficult intubation with a video laryngoscope
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[5] Tracheal Intubation Performed with GlideScope® Video Laryngoscope and Direct Laryngoscopy in Neonates and Infants
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[J]. ANESTHESIOLOGY, 2012, 117 (04) : 914 - 915
[6] Use of a guide wire to facilitate tracheal intubation with the Bullard laryngoscope
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[7] Tracheal Intubation Performed with GlideScope® Video Laryngoscope and Direct Laryngoscopy in Neonates and Infants Reply
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[J]. ANESTHESIOLOGY, 2012, 117 (04) : 915 - 915
[8] Use of the King Vision™ video laryngoscope to facilitate fibreoptic intubation in critical tracheal stenosis proves superior to the GlideScope®
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[J]. CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 2014, 61 (02): : 213 - 214
[9] Use of the King Vision™ video laryngoscope to facilitate fibreoptic intubation in critical tracheal stenosis proves superior to the GlideScope®
Mohamed R. El-Tahan
D. John Doyle
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Mohamed S. Othman
[J]. Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2014, 61 (2): : 213 - 214
[10] Does the Use of Video Laryngoscopy Improve Intubation Outcomes?
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