Randomized Trial of Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults

被引：81

作者：

Janz, David R. ^{[1
]}

Semler, Matthew W. ^{[2
]}

Lentz, Robert J. ^{[2
]}

Matthews, Daniel T. ^{[2
]}

Assad, Tufik R. ^{[2
]}

Norman, Brett C. ^{[2
]}

Keriwala, Raj D. ^{[2
]}

Ferrell, Benjamin A. ^{[2
]}

Noto, Michael J. ^{[2
]}

Shaver, Ciara M. ^{[2
]}

Richmond, Bradley W. ^{[2
]}

Zinggeler, Jeannette ^{[2
]}

Rice, Todd W. ^{[2
]}

机构：

[1] Louisiana State Univ, Sch Med, Dept Med, Sect Pulm & Crit Care Med, New Orleans, LA 70112 USA

[2] Vanderbilt Univ, Sch Med, Dept Med, Div Allergy Pulm & Crit Care Med, Nashville, TN 37212 USA

来源：

CRITICAL CARE MEDICINE | 2016年 / 44卷 / 11期

基金：

美国国家卫生研究院;

关键词：

critical illness; intubation; laryngoscopy; respiratory failure; INTENSIVE-CARE-UNIT; TRACHEAL INTUBATION; EMERGENCY INTUBATION; AIRWAY MANAGEMENT; MULTICENTER; VIDEOLARYNGOSCOPY; PREOXYGENATION; COMPLICATIONS; METAANALYSIS; ETOMIDATE;

D O I：

10.1097/CCM.0000000000001841

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: To evaluate the effect of video laryngoscopy on the rate of endotracheal intubation on first laryngoscopy attempt among critically ill adults. Design: A randomized, parallel-group, pragmatic trial of video compared with direct laryngoscopy for 150 adults undergoing endotracheal intubation by Pulmonary and Critical Care Medicine fellows. Setting: Medical ICU in a tertiary, academic medical center. Patients: Critically ill patients 18 years old or older. Interventions: Patients were randomized 1:1 to video or direct laryngoscopy for the first attempt at endotracheal intubation. Measurements and Main Results: Patients assigned to video (n = 74) and direct (n = 76) laryngoscopy were similar at baseline. Despite better glottic visualization with video laryngoscopy, there was no difference in the primary outcome of intubation on the first laryngoscopy attempt (video 68.9% vs direct 65.8%; p = 0.68) in unadjusted analyses or after adjustment for the operator's previous experience with the assigned device (odds ratio for video laryngoscopy on intubation on first attempt 2.02; 95% CI, 0.82-5.02, p = 0.12). Secondary outcomes of time to intubation, lowest arterial oxygen saturation, complications, and in-hospital mortality were not different between video and direct laryngoscopy. Conclusions: In critically ill adults undergoing endotracheal intubation, video laryngoscopy improves glottic visualization but does not appear to increase procedural success or decrease complications.

引用

页码：1980 / 1987

页数：8

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