Original Research Comparison of video and direct laryngoscope for tracheal intubation in emergency settings: A meta-analysis

Background: Video laryngoscope has recently been introduced as an alternative for performing intubation; however, its validity in emergency settings has not been thoroughly evaluated. Therefore, we conducted a meta-analysis to assess its value compared with direct laryngoscope in emergency settings. Purpose: We conducted a meta-analysis to assess its value compared with direct laryngoscope in emergency settings. Methods: PubMed and EMBASE were searched for studies published through April 2011. Trials that reported data comparing video laryngoscope versus direct laryngoscope-assisted intubation in the emergency room or prehospital locations were included. Results: Four trials reporting a total of 1305 participants were identified. During intubation, video laryngoscope failed to produce high rates of successful intubation (success rate: 0.70; 95% confidence interval [CI]: 0.49e1.01). Time to intubation was not different when using either video laryngoscope or direct laryngoscope (standardized mean difference: 0.19; 95% CI: -0.20d0.58). Furthermore, video laryngoscope seems to achieve a similar glottic view as direct laryngoscope (ratio of better glottic view: 0.96; 95% CI: 0.63e1.46). Conclusion: In the reviewed studies, video laryngoscope was not superior to direct laryngoscope for performing intubation in emergency settings.