A large-scale study indicates that video laryngoscopy decreased the number of attempts needed to achieve endotracheal intubation compared with direct laryngoscopy.

New Cleveland Clinic-led research provides evidence that video laryngoscopy significantly decreased the number of attempts needed to achieve intubation in adult surgical patients who required single-lumen endotracheal intubation for general anesthesia, compared with direct laryngoscopy. 

The research was published in JAMA

The study, which is the largest of its kind, compared hyperangulated video laryngoscopy with direct laryngoscopy in intubating patients requiring single-lumen endotracheal intubation for general anesthesia.  

“Securing airways is a priority for anesthesiologists, surgeons, critical care, and emergency physicians,” says Kurt Ruetzler, MD, an anesthesiologist at Cleveland Clinic, who led the research, in a release. “Successful and timely attempts to intubate greatly decrease poor outcomes such as respiratory and hemodynamic complications, including hypoxemia, aspiration, airway trauma, and even cardiac arrest.” 

Results from the trial, which involved 8,429 eligible surgical procedures in 7,736 patients, demonstrated a significant reduction in the number of intubation attempts when hyperangulated video laryngoscopy was used compared to direct laryngoscopy. More than one intubation attempt was required in 1.7% of patients randomized to receive video laryngoscopy. More than one intubation attempt was required in 7.6% of patients randomized to receive direct laryngoscopy. 

“This is the largest airway trial ever performed,” Ruetzler says in a release. “This trial is going to change clinical practice, as results clearly indicate that video laryngoscopy is superior to direct laryngoscopy and should be the default device in all patients.” 

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