{"title":"Comparison of video laryngoscopy and direct laryngoscopy for urgent intubation in newborn infants: A meta-analysis.","authors":"Wenhao Xu, Peng Wang, Jun Wan, Qingyu Bao, Ruixia Yu, Yuxin Zheng, Xingyu Kuang, Yulin Li, Zhicheng He, C Dominguez, J Luis, Yu Zhang","doi":"10.1016/j.prrv.2024.11.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Securing a stable airway is a critical component in neonatal resuscitation. Compared to direct laryngoscopy, video laryngoscopy provides improved visualization of the glottis, potentially enhancing the success rate of intubation. This systematic review and meta-analysis were conducted to assess and compare the efficacy and safety of video laryngoscopy versus direct laryngoscopy in neonatal intubation.</p><p><strong>Methods: </strong>A thorough search was performed across CENTRAL, Embase, and PubMed databases to identify relevant randomized controlled trials (RCTs) that evaluated the use of video laryngoscopy in comparison with direct laryngoscopy for neonatal intubation. The data extraction and analysis were conducted in alignment with Cochrane guidelines. The primary outcome of interest was the time required for intubation, while secondary outcomes included the number of intubation attempts and the success rate on the first attempt.</p><p><strong>Results: </strong>The meta-analysis included nine RCTs, encompassing a total of 719 neonates. The findings revealed that video laryngoscopy was associated with a longer intubation time (mean difference [MD] 3.23 s, 95 % confidence interval [CI] 2.42 to 4.04; I<sup>2</sup> = 96 %). However, it also significantly improved the first-attempt success rate (risk ratio [RR] 1.31, 95 % CI 1.20 to 1.44; I<sup>2</sup> = 76 %) and borderline reduced the total number of intubation attempts (MD -0.08, 95 % CI -0.15 to 0.00; I<sup>2</sup> = 53 %).</p><p><strong>Conclusions: </strong>While video laryngoscopy is associated with a modest increase in intubation time, it provides clear benefits by enhancing the success rate of first-attempt intubations and reducing the need for multiple attempts in neonatal intubation procedures.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Paediatric Respiratory Reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.prrv.2024.11.002","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Securing a stable airway is a critical component in neonatal resuscitation. Compared to direct laryngoscopy, video laryngoscopy provides improved visualization of the glottis, potentially enhancing the success rate of intubation. This systematic review and meta-analysis were conducted to assess and compare the efficacy and safety of video laryngoscopy versus direct laryngoscopy in neonatal intubation.
Methods: A thorough search was performed across CENTRAL, Embase, and PubMed databases to identify relevant randomized controlled trials (RCTs) that evaluated the use of video laryngoscopy in comparison with direct laryngoscopy for neonatal intubation. The data extraction and analysis were conducted in alignment with Cochrane guidelines. The primary outcome of interest was the time required for intubation, while secondary outcomes included the number of intubation attempts and the success rate on the first attempt.
Results: The meta-analysis included nine RCTs, encompassing a total of 719 neonates. The findings revealed that video laryngoscopy was associated with a longer intubation time (mean difference [MD] 3.23 s, 95 % confidence interval [CI] 2.42 to 4.04; I2 = 96 %). However, it also significantly improved the first-attempt success rate (risk ratio [RR] 1.31, 95 % CI 1.20 to 1.44; I2 = 76 %) and borderline reduced the total number of intubation attempts (MD -0.08, 95 % CI -0.15 to 0.00; I2 = 53 %).
Conclusions: While video laryngoscopy is associated with a modest increase in intubation time, it provides clear benefits by enhancing the success rate of first-attempt intubations and reducing the need for multiple attempts in neonatal intubation procedures.
期刊介绍:
Paediatric Respiratory Reviews offers authors the opportunity to submit their own editorials, educational reviews and short communications on topics relevant to paediatric respiratory medicine. These peer reviewed contributions will complement the commissioned reviews which will continue to form an integral part of the journal.
Subjects covered include:
• Epidemiology
• Immunology and cell biology
• Physiology
• Occupational disorders
• The role of allergens and pollutants
A particular emphasis is given to the recommendation of "best practice" for primary care physicians and paediatricians.
Paediatric Respiratory Reviews is aimed at general paediatricians but it should also be read by specialist paediatric physicians and nurses, respiratory physicians and general practitioners.
It is a journal for those who are busy and do not have time to read systematically through literature, but who need to stay up to date in the field of paediatric respiratory and sleep medicine.