{Reference Type}: Journal Article
{Title}: Impact of universal use of a hyperangulated videolaryngoscope as the first option for all intubations in the ICU: A prospective before-after study.
{Author}: Taboada M;Cariñena A;García F;Alonso S;Iraburu R;De Miguel M;Barreiro L;Dos Santos L;Caruezo V;Muniategui I;Aneiros F;Otero P;Álvarez J;Seoane-Pillado T;
{Journal}: Anaesth Crit Care Pain Med
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 2
{Factor}: 7.025
{DOI}: 10.1016/j.accpm.2024.101402
{Abstract}: <B>BACKGROUND: </B>Tracheal intubation in ICU is associated with high incidence of difficult intubations. The study aimed to investigate whether the "universal" use of a hyperangulated videolaryngoscope would increase the frequency of "easy intubation" in ICU patients compared to direct laryngoscopy.<BR><B>METHODS: </B>A prospective before-after study was conducted. The pre-interventional period (36 months) involved tracheal intubations using direct laryngoscopy as the first intubation option. In the interventional period (18 months) a hyperangulated videolaryngoscope was the first intubation option. The primary outcome was the percentage of patients with "easy intubation" defined as intubation on the first attempt and easy laryngoscopy (modified Cormack-Lehane glottic view of I-IIa). Secondary outcomes included difficult laryngoscopy, operator technical difficulty, and complications.<BR><B>RESULTS: </B>We enrolled 407 patients, 273 in non-interventional period, and 134 in interventional period. Tracheal intubation in the interventional period was associated with higher incidence of "easy intubation" (92.5%) compared with the non-interventional period (75.8%); P <  0.001)). Glottic visualization improved in the interventional period, with a reduced incidence of difficult laryngoscopy (1.5% vs. 22.5%; P <  0.001). The proportion of first-success rate intubation was 92.5% in the interventional period, and 87.8% in the non-interventional period (P =  0.147). Moderate and severe technical difficulty of intubation reported decreased in the interventional period (6% vs. 17.6%; P <  0.001). There was no significant difference between both periods in the incidence of complications.<BR><B>CONCLUSIONS: </B>"Universal" use of hyperangulated videolaryngoscopy for tracheal intubation in patients admitted in ICU improves the percentage of easy intubation compared to direct laryngoscopy.