TY - JOUR
T1 - Tracheal Intubation during Advanced Life Support Using Direct Laryngoscopy versus Glidescope® Videolaryngoscopy by Clinicians with Limited Intubation Experience
T2 - A Systematic Review and Meta-Analysis
AU - van Schuppen, Hans
AU - Wojciechowicz, Kamil
AU - Hollmann, Markus W.
AU - Preckel, Benedikt
N1 - Funding Information: Hans van Schuppen is the Chair of the Medical Board of the Dutch Resuscitation Council and reports grants to his institution from the AMC Foundation, the Zoll Foundation, and Stryker Emergency Care, all outside the submitted work. Kamil Wojciechowicz reports no conflicts of interest. Markus Hollmann is the Executive Section Editor of Pharmacology for Anesthesia & Analgesia, Section Editor of Anesthesiology of the Journal of Clinical Medicine and Editor for Frontiers in Physiology, and reports grants to his institution from ZonMW, EACTA, and ESA, and consulting fees to his institution from CSL Behring, IDD Pharma and MSD, all outside the submitted work. Benedikt Preckel reports grants to his institution from ZonMW, EACTA, and ESA, and consulting fees to his institution from Sensium Healthcare UK, all outside the submitted work. None of the authors have any relationship with Glidescope or Verathon Inc. ® Publisher Copyright: © 2022 by the authors.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - The use of the Glidescope® videolaryngoscope might improve tracheal intubation performance in clinicians with limited intubation experience, especially during cardiopulmonary resuscitation (CPR). The objective of this systematic review and meta-analysis is to compare direct laryngoscopy to Glidescope® videolaryngoscopy by these clinicians. PubMed/Medline and Embase were searched from their inception to 7 July 2020 for randomized controlled trials, including simulation studies. Studies on adult patients or adult-sized manikins were included when direct laryngoscopy was compared to Glidescope® videolaryngoscopy by clinicians with limited experience in tracheal intubation (<10 intubations per year). The primary outcome was the intubation first-pass success rate. Secondary outcomes were time to successful intubation and chest compression interruption duration during intubation. The risk of bias was assessed with the Cochrane risk of bias tool. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). We included 4 clinical trials with 525 patients and 20 manikin trials with 2547 intubations. Meta-analyses favored Glidescope® videolaryngoscopy over direct laryngoscopy regarding first-pass success (clinical trials: risk ratio [RR] = 1.61; 95% confidence interval [CI]: 1.16–2.23; manikin trials: RR = 1.17; 95% CI: 1.09–1.25). Clinical trials showed a shorter time to achieve successful intubation when using the Glidescope® (mean difference = 17.04 s; 95% CI: 8.51–25.57 s). Chest compression interruption duration was decreased when using the Glidescope® videolaryngoscope. The certainty of evidence ranged from very low to moderate. When clinicians with limited intubation experience have to perform tracheal intubation during advanced life support, the use of the Glidescope® videolaryngoscope improves intubation and CPR performance compared to direct laryngoscopy.
AB - The use of the Glidescope® videolaryngoscope might improve tracheal intubation performance in clinicians with limited intubation experience, especially during cardiopulmonary resuscitation (CPR). The objective of this systematic review and meta-analysis is to compare direct laryngoscopy to Glidescope® videolaryngoscopy by these clinicians. PubMed/Medline and Embase were searched from their inception to 7 July 2020 for randomized controlled trials, including simulation studies. Studies on adult patients or adult-sized manikins were included when direct laryngoscopy was compared to Glidescope® videolaryngoscopy by clinicians with limited experience in tracheal intubation (<10 intubations per year). The primary outcome was the intubation first-pass success rate. Secondary outcomes were time to successful intubation and chest compression interruption duration during intubation. The risk of bias was assessed with the Cochrane risk of bias tool. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). We included 4 clinical trials with 525 patients and 20 manikin trials with 2547 intubations. Meta-analyses favored Glidescope® videolaryngoscopy over direct laryngoscopy regarding first-pass success (clinical trials: risk ratio [RR] = 1.61; 95% confidence interval [CI]: 1.16–2.23; manikin trials: RR = 1.17; 95% CI: 1.09–1.25). Clinical trials showed a shorter time to achieve successful intubation when using the Glidescope® (mean difference = 17.04 s; 95% CI: 8.51–25.57 s). Chest compression interruption duration was decreased when using the Glidescope® videolaryngoscope. The certainty of evidence ranged from very low to moderate. When clinicians with limited intubation experience have to perform tracheal intubation during advanced life support, the use of the Glidescope® videolaryngoscope improves intubation and CPR performance compared to direct laryngoscopy.
KW - advanced life support
KW - airway management
KW - cardiopulmonary resuscitation
KW - emergency medical service
KW - tracheal intubation
KW - videolaryngoscopy
UR - http://www.scopus.com/inward/record.url?scp=85141662424&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/jcm11216291
DO - https://doi.org/10.3390/jcm11216291
M3 - Review article
C2 - 36362519
SN - 2077-0383
VL - 11
JO - Journal of clinical medicine
JF - Journal of clinical medicine
IS - 21
M1 - 6291
ER -