Comparison of video and direct laryngoscope for tracheal intubation in emergency settings: A meta-analysis

BackgroundVideo laryngoscope has recently been introduced as an alternative for performing intubation; however, its validity in emergency settings has not been thoroughly evaluated. Therefore, we conducted a meta-analysis to assess its value compared with direct laryngoscope in emergency settings.PurposeWe conducted a meta-analysis to assess its value compared with direct laryngoscope in emergency settings.MethodsPubMed and EMBASE were searched for studies published through April 2011. Trials that reported data comparing video laryngoscope versus direct laryngoscope-assisted intubation in the emergency room or prehospital locations were included.ResultsFour trials reporting a total of 1305 participants were identified. During intubation, video laryngoscope failed to produce high rates of successful intubation (success rate: 0.70; 95% confidence interval [CI]: 0.49–1.01). Time to intubation was not different when using either video laryngoscope or direct laryngoscope (standardized mean difference: 0.19; 95% CI: -0.20—0.58). Furthermore, video laryngoscope seems to achieve a similar glottic view as direct laryngoscope (ratio of better glottic view: 0.96; 95% CI: 0.63–1.46).ConclusionIn the reviewed studies, video laryngoscope was not superior to direct laryngoscope for performing intubation in emergency settings.