Procedures · Intubation technique
Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults
| Design | Multicentre randomised trial, stopped for efficacy at the preplanned interim analysis |
|---|---|
| Treatment | Video laryngoscope |
| Control | Direct laryngoscope |
| Population | 1417 critically ill adults undergoing tracheal intubation in an emergency department or ICU |
| Follow-up | Intubation episode |
| Primary endpoint | Successful intubation on the first attempt |
| Result | Video laryngoscopy produced a higher incidence of successful intubation on the first attempt. The trial was stopped for efficacy at the single preplanned interim analysis. Severe complications during intubation occurred in 151 of 705 (21.4%) with video laryngoscopy and 149 of 712 (20.9%) with direct laryngoscopy. |
| Secondary endpoints | Severe complications, hypoxaemia, oesophageal intubation |
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.
The trial authors, in the published abstract
Ended a long argument in favour of video laryngoscopy for critically ill patients, where a failed first attempt is far more dangerous than in theatre. Stopped early for efficacy, which tends to overestimate effect size.
Prekker ME, Driver BE, Trent SA, et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. N Engl J Med 2023 Aug 3;389(5):418-429.