Cameron Hypes, MD, clinical instructor and critical care fellow, has been selected by The Society of Critical Care Medicine to present his abstract on airway management in the ICU, " Video Laryngoscopy Improves Odds of First Attempt Success at Intubation in the Intensive Care Unit."
Dr. Hypes' research was a retrospective analysis of prospectively collected data in UAMC’s quality improvement database on all intubations in the ICU. The study compared intubation with a newer technology, videolaryngoscopy, to an older technology, direct laryngoscopy. Normally the airway is curved and the vocal cords are not visible when looking into the mouth. Direct laryngoscopy involves putting a metal blade in the mouth to straighten the airway to directly see the vocal cords. Videolaryngoscopy uses a videolaryngoscope, a device with a similar blade, but with a very small camera mounted on the end. The camera feeds video to a monitor, allowing a physician to see "around the corner" and see the vocal cords without completely straightening out the airway.
First attempt success has become the outcome of choice in airway research because an increasing number of attempts are associated with adverse outcomes, such as aspiration and hypoxia. The study found that, controlling for potentially confounding variables like the > specialty of the operator and their experience, video laryngoscopy improved the odds of first attempt success by 2.8 times in the ICU. There were no differences in complication rates between the video and direct groups, but a strong trend suggests that video may lower the odds of esophageal intubation.