Friday, May 29, 2015

Video laryngoscopy versus direct laryngoscopy for intubation during CPR

From a recent study:


This study is a historically controlled clinical design. From May 2011 to April 2013 out-of-hospital cardiac arrest patients were intubated during CPR by novice EPs. CPR data was automatically recorded by pre-installed video and subsequently analysed. The primary outcome was the success rate of the first-attempt at ETI. In addition, time to successful ETI from first-attempt (T-complete), duration of chest compression interruptions, and incidence of oesophageal intubation were compared.


Of 305 patients undergoing ETI, 83 were intubated by novice EPs. The success rate of first-attempt ETI in the VL group (n = 49) was higher than that in the DL group (n = 34, 91.8% vs. 55.9%; p less than 0.001). The median T-complete was significantly shorter with VL than with DL (37 [29–55] vs. 62 [56–110] s; p less than 0.001). Oesophageal intubation was observed only in the DL group (n = 6, 17.6%). The median duration of chest compression interruptions was greater with DL (7 [3–6] s) than with VL (0 [0–0] s). Improvements in ETI during CPR were observed in the VL group after the first 3 months, but not the DL group during regular use for 1 year.


For novice EPs, the VL could significantly improve the first-attempt success in ETI during CPR while the DL couldn’t improve it.

Another similar study here.

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