Efficacy and adverse events profile of videolaryngoscopy in critically ill patients: subanalysis of the INTUBE study.
INTUBE study
adverse events
airway management
critical care
tracheal intubation
videolaryngoscopy
Journal
British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
16
02
2023
revised:
23
03
2023
accepted:
14
04
2023
medline:
25
8
2023
pubmed:
20
5
2023
entrez:
19
5
2023
Statut:
ppublish
Résumé
Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated. This is a subanalysis of a large international prospective cohort of critically ill patients (INTUBE Study) performed from 1 October 2018 to 31 July 2019 and involving 197 sites from 29 countries across five continents. Our primary aim was to determine the first-pass intubation success rates of videolaryngoscopy. Secondary aims were characterising (a) videolaryngoscopy use in the critically ill patient population and (b) the incidence of severe adverse effects compared with direct laryngoscopy. Of 2916 patients, videolaryngoscopy was used in 500 patients (17.2%) and direct laryngoscopy in 2416 (82.8%). First-pass intubation success was higher with videolaryngoscopy compared with direct laryngoscopy (84% vs 79%, P=0.02). Patients undergoing videolaryngoscopy had a higher frequency of difficult airway predictors (60% vs 40%, P<0.001). In adjusted analyses, videolaryngoscopy increased the probability of first-pass intubation success, with an OR of 1.40 (95% confidence interval [CI] 1.05-1.87). Videolaryngoscopy was not significantly associated with risk of major adverse events (odds ratio 1.24, 95% CI 0.95-1.62) or cardiovascular events (odds ratio 0.78, 95% CI 0.60-1.02). In critically ill patients, videolaryngoscopy was associated with higher first-pass intubation success rates, despite being used in a population at higher risk of difficult airway management. Videolaryngoscopy was not associated with overall risk of major adverse events. NCT03616054.
Sections du résumé
BACKGROUND
Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated.
METHODS
This is a subanalysis of a large international prospective cohort of critically ill patients (INTUBE Study) performed from 1 October 2018 to 31 July 2019 and involving 197 sites from 29 countries across five continents. Our primary aim was to determine the first-pass intubation success rates of videolaryngoscopy. Secondary aims were characterising (a) videolaryngoscopy use in the critically ill patient population and (b) the incidence of severe adverse effects compared with direct laryngoscopy.
RESULTS
Of 2916 patients, videolaryngoscopy was used in 500 patients (17.2%) and direct laryngoscopy in 2416 (82.8%). First-pass intubation success was higher with videolaryngoscopy compared with direct laryngoscopy (84% vs 79%, P=0.02). Patients undergoing videolaryngoscopy had a higher frequency of difficult airway predictors (60% vs 40%, P<0.001). In adjusted analyses, videolaryngoscopy increased the probability of first-pass intubation success, with an OR of 1.40 (95% confidence interval [CI] 1.05-1.87). Videolaryngoscopy was not significantly associated with risk of major adverse events (odds ratio 1.24, 95% CI 0.95-1.62) or cardiovascular events (odds ratio 0.78, 95% CI 0.60-1.02).
CONCLUSIONS
In critically ill patients, videolaryngoscopy was associated with higher first-pass intubation success rates, despite being used in a population at higher risk of difficult airway management. Videolaryngoscopy was not associated with overall risk of major adverse events.
CLINICAL TRIAL REGISTRATION
NCT03616054.
Identifiants
pubmed: 37208282
pii: S0007-0912(23)00198-8
doi: 10.1016/j.bja.2023.04.022
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT03616054']
Types de publication
Clinical Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
607-616Investigateurs
Matthew Anstey
(M)
Sandra Colica
(S)
David Brewster
(D)
Shannon Simpson
(S)
Adrian Regli
(A)
Ross O'Grady
(R)
Edward Litton
(E)
Janet Ferrier
(J)
Roland Bartholdy
(R)
Alexis Tabah
(A)
David Bowen
(D)
Rebecca Rowley
(R)
Jonathan Gatward
(J)
Julio Alonso
(J)
Sneha Varkey
(S)
Vijayanand Palaniswamy
(V)
Timothy Chimunda
(T)
Syed T Reza
(ST)
Mozaffer Hossain
(M)
Motiul Islam
(M)
Tarikul Hamid
(T)
Matteo Parotto
(M)
Samareh Ajami
(S)
Andrew Steel
(A)
Lorenzo Del Sorbo
(L)
Alberto Goffi
(A)
Ian Randall
(I)
Neill K J Adhikari
(NKJ)
Tasneem H Mehesry
(TH)
Maria M Vera
(MM)
Guillermo Bugedo
(G)
Gonzalo Labarca
(G)
Monica Silva
(M)
Wuhua Ma
(W)
Yongxing Li
(Y)
Jiayan Wu
(J)
Lun Wu
(L)
Renata Curić Radivojević
(RC)
Marijana Matas
(M)
Višnja Ivančan
(V)
Mario Pavlek
(M)
Slobodan Mihaljević
(S)
Aleksandra Jumić
(A)
Mate Moguš
(M)
Iva Tucić
(I)
Pavel Michalek
(P)
Marek Flaksa
(M)
Hernan Aguirre-Bermeo
(H)
Hugo Tirape-Castro
(H)
Maria F García Aguilera
(MF)
Diana Alvarez Montenegro
(DA)
Diego Morocho Tutillo
(DM)
Jose A Tutillo León
(JA)
Hadrien Winiszewski
(H)
Gael Piton
(G)
Nadia Aissaoui
(N)
Jean-Loup Augy
(JL)
Benoit Champigneulle
(B)
Diane Zlotnik
(D)
Grégoire Muller
(G)
Sophie Jacquier
(S)
Sami Hraiech
(S)
Christophe Guervilly
(C)
Gaetan Plantefeve
(G)
Damien Contou
(D)
Jean Damien Ricard
(JD)
Sebastien Besset
(S)
Gwenhael Colin
(G)
Caroline Pouplet
(C)
Adrien Mirouse
(A)
Elie Azoulay
(E)
Florence Boissier
(F)
Jean-Pierre Frat
(JP)
Emmanuelle Mercier
(E)
Charlotte Salmon-Gandonnière
(C)
Jean-Baptiste Lascarrou
(JB)
Maelle Martin
(M)
Alexis Ferre
(A)
Stephane Legriel
(S)
Cedric Bruel
(C)
Francois Philippard
(F)
Jonathan Zarka
(J)
Frank Chemouni
(F)
Olfa Hamzaoui
(O)
Benjamin Sztrymf
(B)
Yannick Brunin
(Y)
Sébastien Pili-Floury
(S)
Jean-Michel Constantin
(JM)
Thomas Godet
(T)
Tommaso Maraffi
(T)
Armand Mekontso Dessap
(AM)
Mathieu Jozwiak
(M)
Nathalie Marin
(N)
Christophe Guitton
(C)
Nicolas Chudeau
(N)
Alexandre Gros
(A)
Alexandre Boyer
(A)
Eleni Papandreou
(E)
Athanasia Petsiou
(A)
Metaxia Papanikolaou
(M)
Aikaterini Kyparissi
(A)
Maria Tileli
(M)
Alexandros Makris
(A)
Dimitrios Tsiftsis
(D)
Nadia El-Fellah
(N)
Ilias Karametos
(I)
Evi Nakou
(E)
Athanasios Chalkias
(A)
Eleni Arnaoutoglou
(E)
Panagiotis Katsoulis
(P)
Sofia Pouriki
(S)
Kyriaki Vagdatli
(K)
Aikaterini Dimitropoulou
(A)
Amol Kothekar
(A)
Nishanth Baliga
(N)
Sara V Korula
(SV)
Sam Philip
(S)
Lalit Singh
(L)
Nipun Agrawal
(N)
Deepak Jeswani
(D)
Deepti Jeswani
(D)
Simant Jha
(S)
Nitesh Singh
(N)
Mahuya Bhattacharyya
(M)
Amit Das
(A)
Swarna D Kuragayala
(SD)
Subba R Kesavarapu
(SR)
Bhagyesh Shah
(B)
Shuchi Kaushik
(S)
Nilu Sunil
(N)
Kingsly Gnanadurai
(K)
Atul K Singh
(AK)
Dinesh K Singh
(DK)
Sudhir Khunteta
(S)
Kulbhusahn Gupta
(K)
Rhik Sanyal
(R)
Abhirup Midya
(A)
Vijay N Tyagi
(VN)
Prashant Bendre
(P)
Kumar Prashant
(K)
Satish Chaurasia
(S)
Prasanna Mishra
(P)
Sampat Dash
(S)
Omprakash Sundrani
(O)
Jaya Lalwani
(J)
Nikhilesh Jain
(N)
Kehari Agrawal
(K)
Banambar Ray
(B)
Ranjan Meher
(R)
Lakshmikanthcharan Saravanabavan
(L)
Satheesh Munusamy
(S)
Manish Gupta
(M)
Meraj Ahmad
(M)
Kadarapura N Gopalakrishna
(KN)
Bharadwaj Suparna
(B)
Manimala R Surath
(MR)
Kartik Munta
(K)
Bharat Jagiasi
(B)
Anand Srivastava
(A)
Samir Sahu
(S)
Vijay N Tyagi
(VN)
Prashant Bendre
(P)
Sircar Mrinal
(S)
Singh Sujeet Kumar
(SS)
Mehul Shah
(M)
Mayur Patel
(M)
Shrirang Bamane
(S)
Amit Narkhede
(A)
Rajesh Chawla
(R)
Aakanksha Chawla
(A)
Harish Mallapura Maheshwarappa
(HM)
Ramya Ballekatte Manjunath
(RB)
Lua Rahmani
(L)
John G Laffey
(JG)
Roberto Rona
(R)
Annalisa Benini
(A)
Vincenzo Russotto
(V)
Annalisa Rundo
(A)
Annalisa Luzi
(A)
Clelia Esposito
(C)
Moana R Nespoli
(MR)
Andrea Pradella
(A)
Ramona Lungu
(R)
Laura Baccari
(L)
Fernando Chiumiento
(F)
Karim Mariano
(K)
Antonella Cotoia
(A)
Silvia De Rosa
(S)
Elisa Boni
(E)
Salvatore Palmese
(S)
Renato Gammaldi
(R)
Savino Spadaro
(S)
Lida Santoro
(L)
Andrea N Cracchiolo
(AN)
Daniela M Palma
(DM)
Riccardo Pinciroli
(R)
Ilaria Giovannini
(I)
Italo Calamai
(I)
Rosario Spina
(R)
Iacopo Cappellini
(I)
Lorenzo Tutino
(L)
Agrippino Bellissima
(A)
Jessica G Maugeri
(JG)
Ivano Riva
(I)
Fabrizio Fabretti
(F)
Luca Brazzi
(L)
Gabriele Sales
(G)
Giorgia Montrucchio
(G)
Alberto Orsello
(A)
Andrea Costamagna
(A)
Federico G Canavosio
(FG)
Lorella Pelagalli
(L)
Maria E Marcelli
(ME)
Andrea Cortegiani
(A)
Jacopo Tramarin
(J)
Stefania Musso
(S)
Stefano Tarantino
(S)
Ida Di Giacinto
(I)
Anna L Licciardi
(AL)
Luca Montini
(L)
Gennaro De Pascale
(G)
Angelo Giacomucci
(A)
Pierpaolo Russo
(P)
Federico Longhini
(F)
Eugenio Garofalo
(E)
Massimo Ferluga
(M)
Valeria Moro
(V)
Marco Cascella
(M)
Barbara Di Caprio
(B)
Raffaele Di Fenza
(R)
Francesca Nespoli
(F)
Ospedale E Bassini
(OE)
Stefano Muttini
(S)
Angelo Pezzi
(A)
Muhammed Elhadi
(M)
Mohamed Ghula
(M)
Hazem Abdelkarem Ahmed
(HA)
Ala Khaled
(A)
Ahmed Elhadi
(A)
Abdulmueti Alhadi
(A)
Mohd Z Mazlan
(MZ)
Wan Mohd N Wan Hassan
(WMN)
Shahnaz Hasan
(S)
Muhamad F H Jamaluddin
(MFH)
Noryani Mohd Samat
(NM)
Muhamad A Ismail
(MA)
Anita Alias
(A)
Ngu Pei Hwa
(NP)
Ismail Nahla Irtiza
(IN)
Hapiz Khalidah
(H)
Lee Chew Kiok
(LC)
Norbaniza Mohd Nordin
(NM)
Wan N Wan Ismail
(WN)
Mohd N Ali
(MN)
Luis Sánchez-Hurtado
(L)
Otoniel Toledo-Salinas
(O)
Antonio Landaverde
(A)
Miguel A Sosa
(MA)
Mayra Martinez Gonzalez
(MM)
Claudia L Lopez Nava
(CL)
Nandyelly San Juan Roman
(N)
Maria Gonzalez
(M)
Missael Espinoza
(M)
Daira González
(D)
Fernando Flores
(F)
Jesus N Pantoja Leal
(JN)
Luis R Loza Gallardo
(LR)
Paul Young
(P)
Ravi Mistry
(R)
Alexander Browne
(A)
Petra Crone
(P)
Juhi Chandwani
(J)
Sazzad Hossein
(S)
Salman S Koul
(SS)
Rubina Aman
(R)
Syed M Ali
(SM)
Shazia N Akhtar
(SN)
Milosz Jankowski
(M)
Piotr Bielanski
(P)
Wojciech Mudyna
(W)
Pawel Franczyk
(P)
Piotr Galkin
(P)
Lukasz Skowronski
(L)
Tomasz Gaszynski
(T)
Mariusz Piegat
(M)
Nuno Catorze
(N)
Marcia Pinto
(M)
Tiago Leonor
(T)
Marco Fernandes
(M)
Patricia Campos
(P)
Irene Aragão
(I)
Paulo F Costa
(PF)
Daniela G Franco
(DG)
Marta Basto
(M)
Carla Nogueira
(C)
Rui P Cunha
(RP)
Vasco Costa
(V)
Vladimir Lomivorotov
(V)
Artem Nikitenko
(A)
Vladislav Belsky
(V)
Mikhail Furman
(M)
Marat Magomedov
(M)
Vera Baturova
(V)
Alexey Karelov
(A)
Nadezhda Marova
(N)
Ghaleb Almekhlafi
(G)
Adnan Alghamdi
(A)
Emilio Maseda
(E)
Alejandro Suarez de la Rica
(A)
Jesus Flores Gonzalez
(JF)
Miryam Pérez Ruiz
(MP)
Oriol Roca
(O)
Manel Santafe
(M)
Gemma Goma Fernandez
(GG)
Patricia Escudero-Acha
(P)
Alejandro González-Castro
(A)
Christina Agvald-Öhman
(C)
Lina Broman
(L)
Martin Spangfors
(M)
Katrin Hannesdottir
(K)
Elin Persson
(E)
Jon Rosell
(J)
Jesper Sperber
(J)
Annika Ohlsson
(A)
Magnus Von Seth
(M)
Niccolò Pedrotti
(N)
Carl Wahlstrom
(C)
Maria Meirik
(M)
Anna Bandert
(A)
Ditte Krog
(D)
Lu-Cheng Kuo
(LC)
Ming-Hann Shin
(MH)
Jung-Yien Chien
(JY)
Shih-Chi Ku
(SC)
Sheng-Yuan Ruan
(SY)
Chun-Kai Huang
(CK)
Yu-Chang Yeh
(YC)
Anne Chao
(A)
Kuo-Chuan Wang
(KC)
Ching-Tang Chiu
(CT)
Chien-Chang Lee
(CC)
Nai-Kuan Chou
(NK)
Tamas Szakmany
(T)
Benjamin Jones
(B)
Laura Jones
(L)
Valentina Della Torre
(V)
Ayush Sinah
(A)
Alice Quayle
(A)
Olivia Cheetham
(O)
Yadullah Syed
(Y)
Kwabena Mensah
(K)
Christopher Edmunds
(C)
Callum T Kaye
(CT)
Philippe R Bauer
(PR)
Yewande E Odeyemi
(YE)
Joseph Nates
(J)
Andres Laserna
(A)
Jarrod Mosier
(J)
Cameron Hypes
(C)
Eric Gottesman
(E)
Fiore Mastroianni
(F)
Daniel G Fein
(DG)
Dawn Zhao
(D)
Xavier E Fonseca Fuentes
(XE)
Alice Gallo de Moraes
(A)
Benjamin J Sandefur
(BJ)
Philippe R Bauer
(PR)
Akram Khan
(A)
Dubier Matos
(D)
David A Kaufman
(DA)
Andrew Lehr
(A)
Luca Bigatello
(L)
Iwona Bonney
(I)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.