Evidence map›Paper›PMID 37028995›Full record

Observational studyAnnals of emergency medicine2023

Laryngoscopy and Tracheal Intubation: Does Use of a Video Laryngoscope Facilitate Both Steps of the Procedure?

Matthew E Prekker, Stacy A Trent, Arianna Lofrano, Derek W Russell, Christopher R Barnes, Joseph M Brewer, Kevin C Doerschug, John P Gaillard, Sheetal Gandotra, Adit A Ginde and 17 more

Registry-linked trialAbstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Annals of emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07223762 (Hyperangulated Versus Standard Geometry Laryngoscope Blade Trial), which is not on this map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT07223762 naenrolling by invitationnot on this mapstarted 2025, after this paper: background citation

Hyperangulated Versus Standard Geometry Laryngoscope Blade Trial

TypeinterventionalSponsorVanderbilt University Medical CenterRan2025 to 2027Enrolled2,500ConditionsAcute Respiratory FailureArmsHyperangulated video laryngoscope blade, Standard geometry video laryngoscope blade
3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Trial
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  4. Review
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  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Matthew E PrekkerDepartment of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN; Division of Pulmonary, Allergy, and Critical Care Medicine, Hennepin County Medical Center, Minneapolis, MN. Electronic address: Matthew.Prekker@hcmed.org.
Stacy A TrentDepartment of Emergency Medicine, Denver Health, Denver, CO.
Arianna LofranoDivision of Pulmonary, Allergy, and Critical Care Medicine, Hennepin County Medical Center, Minneapolis, MN.
Derek W RussellDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL; Pulmonary Section, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama.
Christopher R BarnesDepartment of Anesthesiology and Critical Care Medicine, University of Washington Harborview Medical Center, Seattle, WA.
Joseph M BrewerDepartment of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Mississippi Medical Center, Jackson, MS.
Kevin C DoerschugDepartment of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa Hospital and Clinics, Iowa City, IA.
John P GaillardDepartment of Anesthesiology, Section on Critical Care, Atrium Health Wake Forest Baptist, Winston-Salem, NC; Department of Emergency Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, NC.
Sheetal GandotraDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL.
Adit A GindeDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.
Shekhar GhamandeDepartment of Medicine, Division of Pulmonary Disease, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, TX.
Kevin W GibbsSection on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Winston-Salem, NC.
Christopher G HughesDepartment of Anesthesiology, Division of Anesthesia Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
David R JanzUniversity Medical Center New Orleans and the Department of Medicine, Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Louisiana State University School of Medicine, New Orleans, LA.
Akram KhanDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University School of Medicine, Portland, OR.
Steven H MitchellDepartment of Emergency Medicine, University of Washington Harborview Medical Center, Seattle, WA.
David B PageDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL.
Todd W RiceDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Wesley H SelfDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.
Lane M SmithPulmonary and Critical Care Associates, Atrium Carolinas Medical Center, Charlotte, NC.
Susan B StempekDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital and Medical Center, Burlington, MA.
Derek J VonderhaarDepartment of Pulmonary and Critical Care Medicine, Ochsner Health, New Orleans, LA.
Jason R WestDepartment of Emergency Medicine, Lincoln Medical Center, The Bronx, New York City, NY.
Micah R WhitsonDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL; Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Jonathan D CaseyDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Matthew W SemlerDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Brian E DriverDepartment of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN.

Funding

Bag-Mask Ventilation to PreVent Hypoxemia during Tracheal Intubation in the Emergency Department: A Clinical TrialK23HL153584 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI CASEY, JONATHAN DALE · 2020 to 2024
$900k
Oxygen Saturation Targets during Mechanical Ventilation of Critically Ill Adults: A Clinical TrialK23HL143053 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI SEMLER, MATTHEW WALL · 2018 to 2022
$854k
Activated Neutrophilic Exosome as Biomarker and Therapeutic Target in COPDK08HL148514 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI RUSSELL, DEREK · 2020 to 2024
$824k
NHLBI NIH HHS K08 HL148514NHLBI NIH HHS K23 HL143053NHLBI NIH HHS K23 HL153584
6 · The paper itself

Abstract

STUDY

objectiveTo compare the effect of the use of a video laryngoscope versus a direct laryngoscope on each step of emergency intubation: laryngoscopy (step 1) and intubation of the trachea (step 2).

methodsIn a secondary observational analysis of data from 2 multicenter, randomized trials that enrolled critically ill adults undergoing tracheal intubation but did not control for laryngoscope type (video laryngoscope vs direct laryngoscope), we fit mixed-effects logistic regression models examining the 1) the association between laryngoscope type (video laryngoscope vs direct laryngoscope) and the Cormack-Lehane grade of view and 2) the interaction between grade of view, laryngoscope type (video laryngoscope vs direct laryngoscope), and the incidence of successful intubation on the first attempt.

resultsWe analyzed 1,786 patients: 467 (26.2%) in the direct laryngoscope group and 1,319 (73.9%) in the video laryngoscope group. The use of a video laryngoscope was associated with an improved grade of view as compared with a direct laryngoscope (adjusted odds ratio for increasingly favorable grade of view 3.14, 95% confidence interval [CI] 2.47 to 3.99). Successful intubation on the first attempt occurred in 83.2% of patients in the video laryngoscope group and 72.2% of patients in the direct laryngoscope group (absolute difference 11.1%, 95% CI 6.5% to 15.6%). Video laryngoscope use modified the association between grade of view and successful intubation on the first attempt such that intubation on the first attempt was similar between video laryngoscope and direct laryngoscope at a grade 1 view and higher for video laryngoscope than direct laryngoscope at grade 2 to 4 views (P<.001 for interaction term).

conclusionsAmong critically ill adults undergoing tracheal intubation, the use of a video laryngoscope was associated both with a better view of the vocal cords and with a higher probability of successfully intubating the trachea when the view of the vocal cords was incomplete in this observational analysis. However, a multicenter, randomized trial directly comparing the effect of a video laryngoscope with a direct laryngoscope on the grade of view, success, and complications is needed.

Indexed as

LaryngoscopesLaryngoscopyAdultCritical IllnessHumansIntubation, IntratrachealTracheaVideo Recording

Identifiers

PMID37028995
PMCPMC11056101

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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.