Historical sample · This article is not presented as new evidence this week.
Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults
Summary
In 1,417 critically ill adults, video laryngoscopy achieved first-pass success in 85.1% versus 70.8% with direct laryngoscopy (difference 14.3 percentage points; 95% CI 9.9 to 18.7). Severe complications occurred in 21.4% versus 20.9% (difference 0.5 points; 95% CI -3.9 to 4.9).
Why it matters
Video laryngoscopy improved first-pass success in ED and ICU intubations, largely performed by trainees; complication benefit was not demonstrated.
Study at a glance
- Design
- Randomized trial
- Population
- Critically ill adults in 17 US EDs and ICUs.
- Sample size
- 1417
- Intervention
- Video laryngoscopy
- Comparator
- Direct laryngoscopy
- Primary endpoint
- Successful intubation on the first attempt
Main findings
- First-pass success: 600/705 vs 504/712.
- Severe complications: 151/705 vs 149/712.
Limitations
Stopped early for efficacy. Most operators were residents or fellows, limiting generalization to experienced operators.
Read the primary source
Full text: Open-access full text available.
Original sourcePMID: 37326325
Source retrieved Oct 26, 2026. Abstract reviewed; full-text access was not used.
Corrections & review history
No corrections recorded. Human review: not yet human-reviewed.