DEVICE (secondary analysis)
Trial question
What is the role of video laryngoscopy in patients undergoing tracheal intubation after cardiac arrest?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
34.0% female
66.0% male
N = 113
113 patients (38 female, 75 male).
Inclusion criteria: critically ill patients undergoing tracheal intubation after cardiac arrest.
Key exclusion criteria: pregnancy; incarceration; immediate need for tracheal intubation; use of videolaryngoscope or direct laryngoscope on the first attempt indicated or contraindicated by operator.
Interventions
N=48 video laryngoscopy (use of a laryngoscope with a camera and a video screen on the first attempt at laryngoscopy).
N=65 direct laryngoscopy (use of a laryngoscope without a camera or a video screen on the first attempt at laryngoscopy).
Primary outcome
Successful intubation on first attempt
83.3%
64.6%
83.3 %
62.5 %
41.6 %
20.8 %
0.0 %
Video
laryngoscopy
Direct
laryngoscopy
Significant
increase ▲
NNT = 5
Significant increase in successful intubation on the first attempt (83.3% vs. 64.6%; AD 18.7%, 95% CI 1.2 to 36.2).
Secondary outcomes
Significant decrease in mean duration of laryngoscopy (48 seconds vs. 98 seconds; MD -50, 95% CI -86.8 to -13.3).
Significant increase in Cormack-Lehane grade I view (70.8% vs. 46.2%; AD 24.7%, 95% CI 5.2 to 44.2).
No significant difference in the rate of death by day 28 (72.9% vs. 70.8%; AD 2.1%, 95% CI -16.4 to 20.7).
Conclusion
In critically ill patients undergoing tracheal intubation after cardiac arrest, video laryngoscopy was superior to direct laryngoscopy with respect to successful intubation on the first attempt.
Reference
Amelia L Muhs, Kevin P Seitz, Edward T Qian et al. Video vs Direct Laryngoscopy for Tracheal Intubation After Cardiac Arrest: A Secondary Analysis of the Direct vs Video Laryngoscope Trial. Chest. 2025 May;167(5):1408-1415.
Open reference URL