Comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation

BACKGROUND: Video laryngoscopes have been introduced in recent years as an alternative choice to facilitate tracheal intubation. We conducted a meta-analysis to assess their value when compared with direct laryngoscopy. METHODS: PubMed and EMBASE were searched up until 24 September 2010. Randomised trials that reported data on the comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation were included. RESULTS: Eleven trials with a total of 1196 participants were identified. During tracheal intubation, video laryngoscopes can achieve a better view of the glottis and have a similar success rate [rate ratio 1.0; 95% confidence interval (CI) 0.99-1.01]. Overall, the time to tracheal intubation was not different between the video laryngoscopes and direct laryngoscopy (standardised mean difference 0.19; 95% CI -0.37-0.75). However, in a subgroup analysis, video laryngoscopes shortened the time taken for difficult intubation (standardised mean difference, -0.75; 95% CI -1.24 to -0.25). CONCLUSION: Video laryngoscopes are a good alternative to direct laryngoscopy during tracheal intubation. The advantage seems to be more prominent when difficult intubation is encountered.