First Attempt Success Rate of Video-assisted versus Direct Laryngoscopy Intubations among Adults in Emergent Situations – A Systematic Review and Meta-Analysis Group I Interns
Ritz Anne De Guzman, MD, Jonathan Gapay, MD, Vhina Therese Sison, MD, Mauvecate Pi perno, MD, ONG, Pierre Eldridge Ong, MD, Jamie Sapida, MD & Maria Nina Grace Bastinen, MD
Alfie Acosta, MD*
Introduction: Airwaymanagementisavitalcomponentinhandlingpatientswhoneeddefinitive airway control in the emergency room. Video-assisted laryngoscopy, may improve successful intubation in these emergent environments.
Methods: PubMed was used in searching for relevant studies comparing the use of video laryngoscopy and direct laryngoscopy. Data analysis was done using Review Manager 5.3 using Risk Ratio of direct laryngoscopy and video-assisted laryngoscopy in terms of first attempt success rate and Mean Difference in terms of time to intubation.
Results: Among the randomized controlled trials, point estimate was 0.77 with 95% con fidence interval. I2 statistics was 92% indicating heterogeneity. Among prospective analyses, the point estimate was 0.98 with 95% confidence interval. I2 statistics was 0% indicating homogeneity among studies. No significant difference was noted with first attempt rates between video-assisted laryngoscopy and direct laryngoscopy (P=0.41). Among the randomized controlled trials comparing time to intubation, I2 statistics of 100% was noted, indicating the heterogeneity. One prospective study noted longer tim e to intubation with video-assisted laryngoscopy (40 seconds) than direct laryngoscopy (30 seconds).
Conclusion: Video laryngoscopy did not exhibit clinically significant improvement in terms of first success rate, and showed longer time to intubation than direct laryngoscopy
*Adviser/Consultant, Department of EmergencyMedicine