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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

Open Access 01.01.2012 | Reports of Original Investigations

Glidescope^® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis

verfasst von: Donald E. G. Griesdale, MD, David Liu, MD, James McKinney, MD, Peter T. Choi, MD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 1/2012

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Abstract

Introduction

The Glidescope^® video-laryngoscopy appears to provide better glottic visualization than direct laryngoscopy. However, it remains unclear if it translates into increased success with intubation.

Methods

We systematically searched electronic databases, conference abstracts, and article references. We included trials in humans comparing Glidescope^® video-laryngoscopy to direct laryngoscopy regarding the glottic view, successful first-attempt intubation, and time to intubation. We generated pooled risk ratios or weighted mean differences across studies. Meta-regression was used to explore heterogeneity based on operator expertise and intubation difficulty.

Results

We included 17 trials with a total of 1,998 patients. The pooled relative risk (RR) of grade 1 laryngoscopy (vs ≥ grade 2) for the Glidescope^® was 2.0 [95% confidence interval (CI) 1.5 to 2.5]. Significant heterogeneity was partially explained by intubation difficulty using meta-regression analysis (P = 0.003). The pooled RR for nondifficult intubations of grade 1 laryngoscopy (vs ≥ grade 2) was 1.5 (95% CI 1.2 to 1.9), and for difficult intubations it was 3.5 (95% CI 2.3 to 5.5). There was no difference between the Glidescope^® and the direct laryngoscope regarding successful first-attempt intubation or time to intubation, although there was significant heterogeneity in both of these outcomes. In the two studies examining nonexperts, successful first-attempt intubation (RR 1.8, 95% CI 1.4 to 2.4) and time to intubation (weighted mean difference −43 sec, 95% CI −72 to −14 sec) were improved using the Glidescope^®. These benefits were not seen with experts.

Conclusion

Compared to direct laryngoscopy, Glidescope^® video-laryngoscopy is associated with improved glottic visualization, particularly in patients with potential or simulated difficult airways.

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Titel: Glidescope® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis
verfasst von: Donald E. G. Griesdale, MD
David Liu, MD
James McKinney, MD
Peter T. Choi, MD
Publikationsdatum: 01.01.2012
Verlag: Springer-Verlag
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 1/2012
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-011-9620-5

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Glidescope^® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis