[Video laryngoscopy in the intensive care unit-A current assessment]

Video laryngoscopy (VL) and direct laryngoscopy (DL) are both intubation methods used on the intensive care unit although it is unclear if the routine use of VL is meaningful in this setting. A systematic literature search was carried out up to April 2024 in the data banks MEDLINE, CENTRAL and LIVIVO. Included were studies in which a comparison between VL and DL in adult patients on the intensive care unit was carried out. The primary endpoint was determined as the rate of the first attempt success (FAS). The secondary endpoints were visualization of the glottis according to Cormack-Lehane, the time to intubation and complications. A total of 13 studies with 4232 intubations were included. The FAS was significantly higher for VL compared to DL (odds ratio, OR = 1.97, 95% confidence interval, CI 1.47-2.64, p < 0.001). The use of VL led to an improved visualization of the glottis according to Cormack-Lehane and was associated with a lower rate of esophageal intubation failure and hypoxemia. This resulted in tendencies for action for the future utilization of VL on the intensive care unit. Further studies should evaluate the experience of the user with intubation, various VL designs and the use of bougies and stylets to be able to make a better assessment of the routine use of VL on the intensive care unit.