A clinical study of comparing the first-attempt success of endotracheal intubation between video laryngoscopy and direct laryngoscopy for trauma patient with suspected cervical injury

Won, Jong Charn; Lee, Sung; Kim, Sin Young; Kim, Jong Won; Hong, Dae Young; Lee, Kyeong Ryong; Baek, Kwang Je; Park, Sang O

J Korean Soc Emerg Med > Volume 33(3); 2022 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2022;33(3): 225-232.

경추 손상이 의심되는 환자에서 직접 후두경과 비디오 후두경 기관삽관 성공률에 대한 임상 비교 연구

원종찬

건국대학교 의학전문대학원 응급의학교실

A clinical study of comparing the first-attempt success of endotracheal intubation between video laryngoscopy and direct laryngoscopy for trauma patient with suspected cervical injury

Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

Correspondence

Sang O Park ,Tel: 02-2030-5551, Fax: 02-2030-5780, Email: empso@kuh.ac.kr,

Received: June 30, 2021; Revised: September 6, 2021 Accepted: October 9, 2021. Published online: June 30, 2022.

ABSTRACT

Objective:
This study aimed to evaluate the effectiveness of video laryngoscopy (VL; Glidescope) compared to direct laryngoscopy (DL) when performing endotracheal intubation (ETI) in trauma patients with cervical spine immobilization.
Method:
This was a retrospective clinical study. A total of 98 trauma patients with cervical spine immobilization were included. These patients underwent intubation using VL and DL from 2009 to 2014 in the emergency department. All data were collected through electronic medical records. The primary outcome was the first-attempt intubation success rate of ETI. Secondary outcomes were complications of ETI, including esophageal intubation and tooth injuries. We compared the outcomes of the two devices.
Results:
VL showed higher first-attempt ETI success rates compared to DL (94.0% vs. 74.5%, P=0.011). There were no statistically significant differences in the ETI complication rates between VL and DL such as esophageal intubation (2.0% vs. 4.3%, P=0.610) and tooth injuries (6.0% vs. 10.6%, P=0.478). The multivariate analysis showed that VL was an independent factor for predicting higher first-attempt intubation success with an odds ratio of 4.538 (95% confidence interval, 1.084-18.988; P=0.038)
Conclusion:
For patients with cervical spine immobilization, VL could provide a higher first-attempt ETI success rate compared to DL in a real clinical setting.

Key words: Intubation; Video laryngoscopy; Direct laryngoscopy; Airway management; Emergency department