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Article

Efficacy and Safety of Video-Laryngoscopy versus Direct Laryngoscopy for Double-Lumen Endotracheal Intubation: A Systematic Review and Meta-Analysis

by
Katarzyna Karczewska
1,
Szymon Bialka
2,
Jacek Smereka
3,4,
Maciej Cyran
4,5,
Grazyna Nowak-Starz
6,
Jaroslaw Chmielewski
7,
Michal Pruc
4,
Pawel Wieczorek
4,8,
Frank William Peacock
9,
Jerzy Robert Ladny
10 and
Lukasz Szarpak
4,11,*
1
Department of Anesthesiology, Masovian Specialist Hospital, 26-617 Radom, Poland
2
Department of Anesthesiology and Intensive Care, Medical University of Silesia, 41-800 Zabrze, Poland
3
Department of Emergency Medical Service, Wroclaw Medical University, 51-618 Wroclaw, Poland
4
Research Unit, Polish Society of Disaster Medicine, 05-806 Warszawa, Poland
5
Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
6
Institute of Health Sciences, Jan Kochanowski University of Kielce, 25-369 Kielce, Poland
7
College of Rehabiliation, 01-234 Warsaw, Poland
8
Research Unit, Polonia University, 42-200 Czestochowa, Poland
9
Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
10
Department of Emergency Medicine, Bialystok Medical University, 15-295 Bialystok, Poland
11
Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, Poland
 
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*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(23), 5524; https://doi.org/10.3390/jcm10235524
Submission received: 26 October 2021 / Revised: 22 November 2021 / Accepted: 24 November 2021 / Published: 25 November 2021
(This article belongs to the Special Issue Airway Management - State of Art)
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Abstract

The available meta-analyses have inconclusively indicated the advantages of video-laryngoscopy (VL) in different clinical situations; therefore, we conducted a systematic review and meta-analysis to determine efficacy outcomes such as successful first attempt or time to perform endotracheal intubation as well as adverse events of VL vs. direct laryngoscopes (DL) for double-lumen intubation. First intubation attempt success rate was 87.9% for VL and 84.5% for DL (OR = 1.64; 95% CI: 0.95 to 2.86; I2 = 61%; p = 0.08). Overall success rate was 99.8% for VL and 98.8% for DL, respectively (OR = 3.89; 95%CI: 0.95 to 15.93; I2 = 0; p = 0.06). Intubation time for VL was 43.4 ± 30.4 s compared to 54.0 ± 56.3 s for DL (MD = −11.87; 95%CI: −17.06 to −6.68; I2 = 99%; p < 0.001). Glottic view based on Cormack–Lehane grades 1 or 2 equaled 93.1% and 88.1% in the VL and DL groups, respectively (OR = 3.33; 95% CI: 1.18 to 9.41; I2 = 63%; p = 0.02). External laryngeal manipulation was needed in 18.4% cases of VL compared with 42.8% for DL (OR = 0.28; 95% CI: 0.20 to 0.40; I2 = 69%; p < 0.001). For double-lumen intubation, VL offers shorter intubation time, better glottic view based on Cormack–Lehane grade, and a lower need for ELM, but comparable first intubation attempt success rate and overall intubation success rate compared with DL.
Keywords: double-lumen tube; endotracheal intubation; one-lung ventilation; systematic review; meta-analysis; randomized controlled trials double-lumen tube; endotracheal intubation; one-lung ventilation; systematic review; meta-analysis; randomized controlled trials

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MDPI and ACS Style

Karczewska, K.; Bialka, S.; Smereka, J.; Cyran, M.; Nowak-Starz, G.; Chmielewski, J.; Pruc, M.; Wieczorek, P.; Peacock, F.W.; Ladny, J.R.; et al. Efficacy and Safety of Video-Laryngoscopy versus Direct Laryngoscopy for Double-Lumen Endotracheal Intubation: A Systematic Review and Meta-Analysis. J. Clin. Med. 2021, 10, 5524. https://doi.org/10.3390/jcm10235524

AMA Style

Karczewska K, Bialka S, Smereka J, Cyran M, Nowak-Starz G, Chmielewski J, Pruc M, Wieczorek P, Peacock FW, Ladny JR, et al. Efficacy and Safety of Video-Laryngoscopy versus Direct Laryngoscopy for Double-Lumen Endotracheal Intubation: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2021; 10(23):5524. https://doi.org/10.3390/jcm10235524

Chicago/Turabian Style

Karczewska, Katarzyna, Szymon Bialka, Jacek Smereka, Maciej Cyran, Grazyna Nowak-Starz, Jaroslaw Chmielewski, Michal Pruc, Pawel Wieczorek, Frank William Peacock, Jerzy Robert Ladny, and et al. 2021. "Efficacy and Safety of Video-Laryngoscopy versus Direct Laryngoscopy for Double-Lumen Endotracheal Intubation: A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 10, no. 23: 5524. https://doi.org/10.3390/jcm10235524

APA Style

Karczewska, K., Bialka, S., Smereka, J., Cyran, M., Nowak-Starz, G., Chmielewski, J., Pruc, M., Wieczorek, P., Peacock, F. W., Ladny, J. R., & Szarpak, L. (2021). Efficacy and Safety of Video-Laryngoscopy versus Direct Laryngoscopy for Double-Lumen Endotracheal Intubation: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 10(23), 5524. https://doi.org/10.3390/jcm10235524

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