Department of Emergency Internal Medicine, Daxing District People's Hospital (Capital Medical University Daxing Teaching Hospital), Beijing, China.
J Healthc Eng. 2022 Jan 7;2022:1474298. doi: 10.1155/2022/1474298. eCollection 2022.
Video laryngoscopy has been associated with some orotracheal intubations and enhances the glottic view at time of laryngoscopy and the success rate of the intubation in patients from the emergency department and the intensive care unit. In usual cases, direct laryngoscopy is performed among the patients from the emergency department or the intensive care unit. In this systematic review and meta-analysis, we draw the comparison between the video laryngoscopy and direct laryngoscopy for the emergency orotracheal intubation.
The objective of the study was to identify the clinical efficacy of video laryngoscopy versus laryngoscopy for emergency orotracheal intubation.
MEDLINE, CENTRAL, EMBASE, and Web of Science databases were analyzed from 2003 to 2020. Keywords used for searching the studies were "laryngoscopy," "video laryngoscopy," "direct laryngoscopy," "emergency department," "intensive care unit," "orotracheal," "video laryngoscope," "glidescope," "airway scope," "airway," "Macintosh laryngoscopy," "airway management," "tracheal intubation," "orotracheal intubation," and "intubation."
The first-pass intubation success rates in the intensive care unit were low in video laryngoscopy with 95% CI 1.21 (1.13-1.30) and heterogeneity 2 = 78% favoring direct laryngoscopy nonsignificantly with low heterogeneity. Odds ratio for airway trauma or dental damage was 0.67, 95% CI (0.18-2.54), reported higher in video laryngoscopy. Complications with oesophageal laryngoscopy were higher in video laryngoscopy with risk ratio 0.16, 95% CI (0.09-0.29), odds ratio 0.88, 95% CI (0.65-1.18) for sever hypoxemia, risk ratio 1.53, 95% CI (1.02-2.28) for cardiovascular collapse, risk ratio with 95% CI 1.11 (0.59-2.07) for aspiration complications, and odds ratio 1.32, 95% CI (0.95, 1.85) for Inexperienced medical staff handling laryngoscopy.
No significant efficiency was noticed in using video laryngoscopy when compared with direct laryngoscopy with the available data. The data reported in studies are not enough for efficient clinical analysis of the benefits of using video laryngoscopy over direct laryngoscopy. Thus, information such as length of stay, mortality, sever complications, and length of hospital stay must be reported.
视频喉镜与一些经口气管插管有关，并在进行喉镜检查时增强了声门视图，并提高了急诊科和重症监护病房患者的插管成功率。在常规情况下，对急诊科或重症监护病房的患者进行直接喉镜检查。在这项系统评价和荟萃分析中，我们比较了视频喉镜和直接喉镜在紧急经口气管插管中的作用。
本研究的目的是确定视频喉镜与喉镜用于紧急经口气管插管的临床疗效。
对 2003 年至 2020 年期间的 MEDLINE、CENTRAL、EMBASE 和 Web of Science 数据库进行了分析。用于搜索研究的关键词是“喉镜”，“视频喉镜”，“直接喉镜”，“急诊科”，“重症监护病房”，“经口”，“视频喉镜”，“Glidescope”，“气道镜”，“气道”，“Macintosh 喉镜”，“气道管理”，“气管插管”，“经口气管插管”和“插管”。
重症监护病房的首次插管成功率在视频喉镜中较低，95%CI 为 1.21（1.13-1.30），异质性为 2=78%，与直接喉镜的差异无统计学意义，但异质性较低。气道创伤或牙齿损伤的优势比为 0.67，95%CI（0.18-2.54），报告在视频喉镜中较高。食管喉镜并发症的风险比在视频喉镜中较高，为 0.16，95%CI（0.09-0.29），比值比为 0.88，95%CI（0.65-1.18），严重低氧血症的比值比为 0.88，95%CI（0.65-1.18），心血管衰竭的比值比为 0.88，95%CI（0.65-1.18），并发症的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），并发症的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29），心血管衰竭的比值比为 0.16，95%CI（0.09-0.29）。视频喉镜处理时，经验不足的医护人员发生严重低氧血症的比值比为 1.32，95%CI（0.95，1.85）。
与直接喉镜相比，使用视频喉镜没有明显的效率。研究报告的数据不足以对使用视频喉镜相对于直接喉镜的益处进行有效的临床分析。因此，必须报告诸如住院时间、死亡率、严重并发症和住院时间等信息。
