Observational studyInternal and emergency medicine2017
Failure to achieve first attempt success at intubation using video laryngoscopy is associated with increased complications.
Observational study in Internal and emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Pooled it
- Channelled versus nonchannelled Macintosh videolaryngoscope blades in patients with a cervical collar: a randomized controlled noninferiority trial.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Trial
- Peri-intubation Cardiovascular Collapse During Emergency Airway Management.Pulmonary therapy · 2025Review
- Tracheal intubation in critically ill adults with a physiologically difficult airway. An international Delphi study.Intensive care medicine · 2024Article
- Video Versus Direct Laryngoscopy for Intubation: Updated Systematic Review and Meta-Analysis.Cureus · 2024Review
- Comparison of Force During the Endotracheal Intubation of Commercial Simulation Manikins.Cureus · 2023Article
- Appraising First-Pass Success: During Emergency Airway Management, What Does It Mean to Be Successful?Annals of the American Thoracic Society · 2023Article
- Intubation first-pass success in a high performing pre-hospital critical care system is not associated with 30-day mortality: a registry study of 4496 intubation attempts.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Observational
- Impact of Macintosh blade size on endotracheal intubation success in intensive care units: a retrospective multicenter observational MacSize-ICU study.Intensive care medicine · 2022Observational
- Direct vs Video Laryngoscopy for Difficult Airway Patients in the Emergency Department: A National Emergency Airway Registry Study.The western journal of emergency medicine · 2022Article
- Describing the Challenges of Prehospital Rapid Sequence Intubation by Macintosh Blade Video Laryngoscopy Recordings.Prehospital and disaster medicine · 2022Article
- Video screen visualization patterns when using a video laryngoscope for tracheal intubation: A systematic review.Journal of the American College of Emergency Physicians open · 2022Review
- New dimensions in airway management: risks for healthcare staff.Anaesthesia · 2020Article
- Comparison of Direct and Video Laryngoscopes during Different Airway Scenarios Performed by Experienced Paramedics: A Randomized Cross-Over Manikin Study.BioMed research international · 2020Article
- Optimizing Rapid Sequence Intubation for Medical and Trauma Patients in the Pediatric Emergency Department.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The purpose of this investigation was to investigate the association between first attempt success and intubation-related complications in the Intensive Care Unit after the widespread adoption of video laryngoscopy. We further sought to characterize and identify the predictors of complications that occur despite first attempt success. This was a prospective observational study of consecutive intubations performed with video laryngoscopy at an academic medical Intensive Care Unit. Operator, procedural, and complication data were collected. Multivariable logistic regression was used to examine the relationship between the intubation attempts and the occurrence of one or more complications. A total of 905 patients were intubated using a video laryngoscope. First attempt success occurred in 739 (81.7 %), whereas >1 attempt was needed in 166 (18.3 %). One or more complications occurred in 146 (19.8 %) of those intubated on the first attempt versus 107 (64.5 %, p < 0.001) of those requiring more than one attempt. Logistic regression analysis shows that >1 attempt is associated with 6.4 (95 % CI 4.4-9.3) times the adjusted odds of at least one complication. Pre-intubation predictors of at least one complication despite first attempt success include vomit or edema in the airway as well as the presence of hypoxemia or hypotension. There are increased odds of complications with even a second attempt at intubation in the Intensive Care Unit. Complications occur frequently despite a successful first attempt, and as such, the goal of airway management should not be simply first attempt success, but instead first attempt success without complications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.