The large-scale study indicates that video laryngoscopy decreased the number of attempts needed to achieve endotracheal intubation compared with direct laryngoscopy
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New Cleveland Clinic-led research provides evidence that video laryngoscopy significantly decreased the number of attempts needed to achieve intubation in adult surgical patients who required single-lumen endotracheal intubation for general anesthesia, compared with direct laryngoscopy. The research was published today in JAMA.
Video laryngoscopy utilizes video camera technology to visualize airway structures and facilitate endotracheal intubation.
The study, which is the largest of its kind, compared hyperangulated video laryngoscopy with direct laryngoscopy in intubating patients requiring single-lumen endotracheal intubation for general anesthesia.
“Securing airways is a priority for anesthesiologists, surgeons, critical care and emergency physicians,” said Kurt Ruetzler, M.D., an anesthesiologist at Cleveland Clinic, who led the research. “Successful and timely attempts to intubate greatly decrease poor outcomes such as respiratory and hemodynamic complications, including hypoxemia, aspiration, airway trauma and even cardiac arrest.”
Results from the trial, which involved 8,429 eligible surgical procedures in 7,736 patients, demonstrated a significant reduction in the number of intubation attempts when hyperangulated video laryngoscopy was used compared to direct laryngoscopy. More than one intubation attempt was required in 1.7% of patients randomized to receive video laryngoscopy. More than one intubation attempt was required in 7.6% of patients randomized to receive direct laryngoscopy.
“This is the largest airway trial ever performed,” Dr. Ruetzler said. “This trial is going to change clinical practice, as results clearly indicate that video laryngoscopy is superior to direct laryngoscopy and should be the default device in all patients.”
Dr. Ruetzler’s co-authors include: Sergio Bustamante, M.D.; Marc T. Schmidt; Federico Almonacid-Cardenas, M.D.; Andra Duncan, M.D.; Andrew Bauer, M.D.; Alparslan Turan, M.D.; Nikolaos J. Skubas, M.D.; Daniel I. Sessler, M.D.; for the Collaborative VLS Trial Group.
This trial was supported by departmental and institutional support only. The GlideScope video laryngoscopes and GlideRite stylets were provided by Verathon Inc.
Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. Cleveland Clinic is consistently recognized in the U.S. and throughout the world for its expertise and care. Among Cleveland Clinic’s 81,000 employees worldwide are more than 5,743 salaried physicians and researchers, and 20,160 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,690-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, 276 outpatient facilities, including locations in northeast Ohio; Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2023, there were 13.7 million outpatient encounters, 323,000 hospital admissions and observations, and 301,000 surgeries and procedures throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 132 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/CleClinicNews. News and resources available at newsroom.clevelandclinic.org.
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