Efficacy and adverse events profile of videolaryngoscopy in critically ill patients : subanalysis of the INTUBE study
Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated.
METHODS: This is a subanalysis of a large international prospective cohort of critically ill patients (INTUBE Study) performed from 1 October 2018 to 31 July 2019 and involving 197 sites from 29 countries across five continents. Our primary aim was to determine the first-pass intubation success rates of videolaryngoscopy. Secondary aims were characterising (a) videolaryngoscopy use in the critically ill patient population and (b) the incidence of severe adverse effects compared with direct laryngoscopy.
RESULTS: Of 2916 patients, videolaryngoscopy was used in 500 patients (17.2%) and direct laryngoscopy in 2416 (82.8%). First-pass intubation success was higher with videolaryngoscopy compared with direct laryngoscopy (84% vs 79%, P=0.02). Patients undergoing videolaryngoscopy had a higher frequency of difficult airway predictors (60% vs 40%, P<0.001). In adjusted analyses, videolaryngoscopy increased the probability of first-pass intubation success, with an OR of 1.40 (95% confidence interval [CI] 1.05-1.87). Videolaryngoscopy was not significantly associated with risk of major adverse events (odds ratio 1.24, 95% CI 0.95-1.62) or cardiovascular events (odds ratio 0.78, 95% CI 0.60-1.02).
CONCLUSIONS: In critically ill patients, videolaryngoscopy was associated with higher first-pass intubation success rates, despite being used in a population at higher risk of difficult airway management. Videolaryngoscopy was not associated with overall risk of major adverse events.
CLINICAL TRIAL REGISTRATION: NCT03616054.
| Errataetall: |
CommentIn: Br J Anaesth. 2023 Sep;131(3):434-438. - PMID 37507261 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:131 |
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| Enthalten in: |
British journal of anaesthesia - 131(2023), 3 vom: 17. Sept., Seite 607-616 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Russotto, Vincenzo [VerfasserIn] |
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| Links: |
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| Themen: |
Adverse events |
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| Anmerkungen: |
Date Completed 25.08.2023 Date Revised 30.11.2023 published: Print-Electronic ClinicalTrials.gov: NCT03616054 CommentIn: Br J Anaesth. 2023 Sep;131(3):434-438. - PMID 37507261 Citation Status MEDLINE |
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| doi: |
10.1016/j.bja.2023.04.022 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357107985 |
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| 100 | 1 | |a Russotto, Vincenzo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Efficacy and adverse events profile of videolaryngoscopy in critically ill patients |b subanalysis of the INTUBE study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 25.08.2023 | ||
| 500 | |a Date Revised 30.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT03616054 | ||
| 500 | |a CommentIn: Br J Anaesth. 2023 Sep;131(3):434-438. - PMID 37507261 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated | ||
| 520 | |a METHODS: This is a subanalysis of a large international prospective cohort of critically ill patients (INTUBE Study) performed from 1 October 2018 to 31 July 2019 and involving 197 sites from 29 countries across five continents. Our primary aim was to determine the first-pass intubation success rates of videolaryngoscopy. Secondary aims were characterising (a) videolaryngoscopy use in the critically ill patient population and (b) the incidence of severe adverse effects compared with direct laryngoscopy | ||
| 520 | |a RESULTS: Of 2916 patients, videolaryngoscopy was used in 500 patients (17.2%) and direct laryngoscopy in 2416 (82.8%). First-pass intubation success was higher with videolaryngoscopy compared with direct laryngoscopy (84% vs 79%, P=0.02). Patients undergoing videolaryngoscopy had a higher frequency of difficult airway predictors (60% vs 40%, P<0.001). In adjusted analyses, videolaryngoscopy increased the probability of first-pass intubation success, with an OR of 1.40 (95% confidence interval [CI] 1.05-1.87). Videolaryngoscopy was not significantly associated with risk of major adverse events (odds ratio 1.24, 95% CI 0.95-1.62) or cardiovascular events (odds ratio 0.78, 95% CI 0.60-1.02) | ||
| 520 | |a CONCLUSIONS: In critically ill patients, videolaryngoscopy was associated with higher first-pass intubation success rates, despite being used in a population at higher risk of difficult airway management. Videolaryngoscopy was not associated with overall risk of major adverse events | ||
| 520 | |a CLINICAL TRIAL REGISTRATION: NCT03616054 | ||
| 650 | 4 | |a Clinical Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a INTUBE study | |
| 650 | 4 | |a adverse events | |
| 650 | 4 | |a airway management | |
| 650 | 4 | |a critical care | |
| 650 | 4 | |a tracheal intubation | |
| 650 | 4 | |a videolaryngoscopy | |
| 700 | 1 | |a Lascarrou, Jean Baptiste |e verfasserin |4 aut | |
| 700 | 1 | |a Tassistro, Elena |e verfasserin |4 aut | |
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| 700 | 1 | |a Antolini, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Bauer, Philippe |e verfasserin |4 aut | |
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| 700 | 1 | |a Camporota, Luigi |e verfasserin |4 aut | |
| 700 | 1 | |a Putensen, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Pelosi, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Sorbello, Massimiliano |e verfasserin |4 aut | |
| 700 | 1 | |a Higgs, Andy |e verfasserin |4 aut | |
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| 700 | 1 | |a Grasselli, Giacomo |e verfasserin |4 aut | |
| 700 | 1 | |a Valsecchi, Maria G |e verfasserin |4 aut | |
| 700 | 1 | |a Fumagalli, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Foti, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Caironi, Pietro |e verfasserin |4 aut | |
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| 700 | 1 | |a Laffey, John G |e verfasserin |4 aut | |
| 700 | 1 | |a Myatra, Sheila N |e verfasserin |4 aut | |
| 700 | 0 | |a INTUBE Study Investigators |e verfasserin |4 aut | |
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| 700 | 1 | |a Regli, Adrian |e investigator |4 oth | |
| 700 | 1 | |a O'Grady, Ross |e investigator |4 oth | |
| 700 | 1 | |a Litton, Edward |e investigator |4 oth | |
| 700 | 1 | |a Ferrier, Janet |e investigator |4 oth | |
| 700 | 1 | |a Bartholdy, Roland |e investigator |4 oth | |
| 700 | 1 | |a Tabah, Alexis |e investigator |4 oth | |
| 700 | 1 | |a Bowen, David |e investigator |4 oth | |
| 700 | 1 | |a Rowley, Rebecca |e investigator |4 oth | |
| 700 | 1 | |a Gatward, Jonathan |e investigator |4 oth | |
| 700 | 1 | |a Alonso, Julio |e investigator |4 oth | |
| 700 | 1 | |a Varkey, Sneha |e investigator |4 oth | |
| 700 | 1 | |a Palaniswamy, Vijayanand |e investigator |4 oth | |
| 700 | 1 | |a Chimunda, Timothy |e investigator |4 oth | |
| 700 | 1 | |a Reza, Syed T |e investigator |4 oth | |
| 700 | 1 | |a Hossain, Mozaffer |e investigator |4 oth | |
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