Seeing is believing: getting the best out of videolaryngoscopy

Kelly, F. E.; Cook, Tim

doi:10.1093/bja/aew052

Cited by 105 publications

(109 citation statements)

References 50 publications

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“…The benefits of VL are most significant in patients with difficult airways, as it converts "blind" intubations into intubations under visual control (9). In patients with difficult airways, VL can provide a higher intubation success rate and a shorter intubation time than DL (10)(11)(12).…”

Section: What Is Efficacy Of Videolaryngoscopy?mentioning

confidence: 99%

“…In fact, success with the application of any device is probable to be increased as experience is accumulated. If VL is used for all patients, experience and skill would undoubtedly increase, thus, number of intubation attempts and complications of multiple attempts would decrease, and patient care would improve (10). It has been suggested that the optimal VLs should be offered to all patients without significant limitations and not only in those considered most difficult (12).…”

Section: Should Videolaryngoscopy Be Used For All Intubations?mentioning

confidence: 99%

“…Other barriers against using VLs as primary intubation devices are likely to be their performance controversy and cost (10). Given that VL does not offer anything more than DL when tracheal intubation is performed by experienced operators in patients with easy airways and cannot give a 100% success rate in patients with difficult airways, some anesthesiologists have appealed that DL should continue to be taught and practiced, and VL should not replace DL in patients with normal or difficult airways (9,69).…”

Section: Should Videolaryngoscopy Be Used For All Intubations?mentioning

confidence: 99%

“…As compared to angulated VLs, moreover, Macintosh-type VLs could reduce stylet use in patients with normal airways as it displaces soft tissues in the fashion of a DL and affords room for tracheal tube insertion (63). These feature of Macintosh-type VLs make them very suitable to serve as standard tools for routine intubation (10,63).…”

mentioning

confidence: 99%

“…As mentioned above, each device has unique properties that may be advantageous in some conditions, but limiting in other situations (10). To manage various airway conditions expeditiously and safely, thus, VLs must be selected as to indications and anesthesiologists must master several different devices (4).…”

mentioning

confidence: 99%

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Videolaryngoscopy in Airway Management: What Every Anesthesiologist Should Know!

Xue¹,

Liu²,

Li³

et al. 2018

J Anesth Perioper Med

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Aim of review:The aim of this article is to convey several hotspot issues regarding the use of videolaryngoscopy (VL) in airway management that anesthesiologists are often concerned. Methods: Recent literature in the past 20 years about the use of VL in the clinical airway management were searched from the Pubmed and Cochrane databases and reviewed, in order to determine the strengths and weakness of VL and conflicting issues regarding the role of VL in airway management. Recent findings: The benefits of VL are most significant in patients with difficult airways, with an improved laryngeal view and an increased success rate of intubation. However, VL cannot give a 100% success rate and there is no specific evaluation system of difficult or failed VL as with direct laryngoscopy. Awake VL-assisted intubation is a useful alternative to awake fiberoptic intubation, but the fiberoptic bronchoscope cannot be discarded and still is gold standard tool of difficult airway management. There are several differenttype VLs available and their efficacies may be different between devices due to various designs and shapes. Due to the limited number of comparative studies, however, there is inconclusive evidence to recommend which VL design is more advantageous in various clinical situations. A Macintosh-type VL allows residents to learn laryngoscopy and intubation more quickly and effectively. Given that VL has tremendous advantages, it should be used as the first-line device for all tracheal intubations. Summary: The introduction of VL has resulted in a dramatic transformation of clinical airway management and is seen as the evolutionary step in intubation technology. There are considerable disagreements over the role of VL in airway management and the need of more investigation, but VL continues to get popularity both inside and outside the operating room. With increasing use of VL in airway management, experience and skill will undoubtedly increase, and the evidence will suggest that the attempt numbers and complications of intubations may be decreased, and patient safety can be improved. (Funded by the Major Project of Zhejiang Science and Technology Fund.) ABSTRACT

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Section: What Is Efficacy Of Videolaryngoscopy?mentioning

confidence: 99%

Section: Should Videolaryngoscopy Be Used For All Intubations?mentioning

confidence: 99%

Section: Should Videolaryngoscopy Be Used For All Intubations?mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Videolaryngoscopy in Airway Management: What Every Anesthesiologist Should Know!

Xue¹,

Liu²,

Li³

et al. 2018

J Anesth Perioper Med

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Intubation With Video Laryngoscopy vs Direct Laryngoscopy

Xue

Liu

2017

JAMA

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Universal C‐MAC® videolaryngoscope use in adult patients: a single‐centre experience

Penders,

Kelly,

Cook

2024

Anaesthesia Reports

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SummaryUniversal use of Storz C‐MAC® videolaryngoscopes was implemented for adult tracheal intubations in the operating theatres, intensive care unit and emergency department at Royal United Hospitals Bath NHS Foundation Trust in 2017. We report data from 1099 intubations from March 2020 to March 2022, collected contemporaneously and anonymously using a smartphone app, representing an estimated 18% of intubations in operating theatres and 30% of intubations in other locations during this period. Intubation success was 100%. The first‐pass success rate was 87.3% overall: 87% with a Macintosh videolaryngoscope, 92% with a hyperangulated videolaryngoscope and 81% for users with ≤ 20 previous uses. First‐pass success without complications was 87% overall: 87% in operating theatres (836/962), 93% in the emergency department (38/41) and 83% in the intensive care unit (73/88). Complications occurred during 0.6% of intubations: 0/962 in operating theatres and 7/137 in non‐theatre locations. The rate of complications was unaltered by blade type (Macintosh 5/994 vs. hyperangulated 2/105, p = 0.14); intubator experience with the device (≤ 20 previous clinical uses 2/260 vs. > 20 previous uses 5/832, p = 0.67) and use of airborne personal protective equipment (PPE 6/683 vs. no‐PPE 1/410, p = 0.27). Complication rates increased outside theatres (theatres 0/963 vs. non‐theatre 7/136, p < 0.001) and during rapid sequence induction (RSI 6/379 (1.6%) vs. non‐RSI 1/720 (0.1%), p = 0.008).

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Seeing is believing: getting the best out of videolaryngoscopy

Cited by 105 publications

References 50 publications

Videolaryngoscopy in Airway Management: What Every Anesthesiologist Should Know!

Videolaryngoscopy in Airway Management: What Every Anesthesiologist Should Know!

Intubation With Video Laryngoscopy vs Direct Laryngoscopy

Universal C‐MAC® videolaryngoscope use in adult patients: a single‐centre experience

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