PMID- 23823612
OWN - NLM
STAT- MEDLINE
DCOM- 20131204
LR  - 20220408
IS  - 2163-0763 (Electronic)
IS  - 2163-0755 (Linking)
VI  - 75
IP  - 2
DP  - 2013 Aug
TI  - Effect of video laryngoscopy on trauma patient survival: a randomized controlled 
      trial.
PG  - 212-9
LID - 10.1097/TA.0b013e318293103d [doi]
AB  - BACKGROUND: Many resuscitation scenarios include the use of emergency intubation 
      to support injured patients. New video-guided airway management technology is 
      available, which may minimize the risk to patients from this procedure. METHODS: 
      This was a controlled clinical trial conducted in the trauma receiving unit in a 
      university-affiliated urban hospital in which 623 consecutive adult patients 
      requiring emergency airway management were prospectively randomized to intubation 
      with either the direct laryngoscope (DL) or the GlideScope video laryngoscope 
      (GVL) device. RESULTS: The primary outcome was survival to hospital discharge. 
      There was no significant difference in mortality between the GVL group (28 [9%] 
      of 303) and the DL group (24 [8%] of 320) (p = 0.43) for all patients. Within a 
      smaller cohort identified retrospectively, there was a higher mortality rate seen 
      in the subgroup of patients with severe head injuries (head Abbreviated Injury 
      Scale [AIS] score > 3) who were randomized to intubation with GVL (22 [30%] of 
      73) versus DL (16 [14%] of 112) (p = 0.047). Among all patients, median 
      intubation duration in seconds was significantly higher for the GVL group 
      (median, 56; interquartile range, 40-81) than for the DL group (median, 40; 
      interquartile range, 24-68) (p < 0.001). Among those with severe head injuries, 
      median intubation duration in seconds was also significantly higher for the GVL 
      group (median, 74) than for the DL group (median, 65) (p < 0.003). 
      Correspondingly, this group also experienced a greater incidence of low oxygen 
      saturations of 80% or less (27 [50%] of 54 for the GVL group and 15 [24%] of 63 
      for the DL group; p = 0.004). There were no significant differences between the 
      two groups in first-pass success (80% for GVL and 81% for DL, p = 0.46). 
      CONCLUSION: Use of the GlideScope did not influence survival to hospital 
      discharge among all patients and was associated with longer intubation times than 
      direct laryngoscopy. Among the video laryngoscope cohort, a smaller subgroup of 
      severe head injury trauma patients identified retrospectively seemed to be 
      associated with a greater incidence of hypoxia of 80% or less and mortality.
FAU - Yeatts, Dale J
AU  - Yeatts DJ
AD  - Department of Emergency Medicine, University of Maryland School of Medicine, 
      Baltimore, Maryland, USA. dyeatts@umm.edu
FAU - Dutton, Richard P
AU  - Dutton RP
FAU - Hu, Peter F
AU  - Hu PF
FAU - Chang, Yu-Wei W
AU  - Chang YW
FAU - Brown, Clayton H
AU  - Brown CH
FAU - Chen, Hegang
AU  - Chen H
FAU - Grissom, Thomas E
AU  - Grissom TE
FAU - Kufera, Joseph A
AU  - Kufera JA
FAU - Scalea, Thomas M
AU  - Scalea TM
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Trauma Acute Care Surg
JT  - The journal of trauma and acute care surgery
JID - 101570622
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Intubation, Intratracheal/instrumentation/*methods
MH  - Laryngoscopes
MH  - Laryngoscopy/instrumentation/*methods
MH  - Male
MH  - Middle Aged
MH  - Survival Analysis
MH  - Time Factors
MH  - Trauma Centers/statistics & numerical data
MH  - Wounds and Injuries/mortality/*therapy
MH  - Young Adult
EDAT- 2013/07/05 06:00
MHDA- 2013/12/16 06:00
CRDT- 2013/07/05 06:00
PHST- 2013/07/05 06:00 [entrez]
PHST- 2013/07/05 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - 10.1097/TA.0b013e318293103d [doi]
PST - ppublish
SO  - J Trauma Acute Care Surg. 2013 Aug;75(2):212-9. doi: 10.1097/TA.0b013e318293103d.