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Video Laryngoscopy vs Direct Laryngoscopy on Successful First-Pass Orotracheal Intubation Among ICU Patients: A Randomized Clinical Trial

Journal Club Summary

Methodology Score: 4/5                   
Usefulness Score:  3/5

Lascarrou JB, et al. JAMA. 2017 Feb 7;317(5):483-493.
 
This study was an open-label, randomized clinical trial conducted at 7 ICUs in France that found video laryngoscopy compared with direct laryngoscopy did not improve first-pass orotracheal intubation rates or median time to successful intubation in an ICU population. Overall, this study adds to a growing body of evidence that video laryngoscopy does not improve first pass orotracheal intubation rates.
By: Dr. Jeffrey Landreville  

Epi lesson

Outcomes may include survival, clinical events (e.g. strokes or myocardial infarction), patient-reported outcomes (e.g. symptoms, quality of life), process outcomes (length of stay, intubation, imaging), adverse events, and economic outcomes (e.g. cost and resource use). Ideally the most important relevant outcome will be the primary outcome of the study, e.g. mortality for cardiac arrest, pain relief for analgesic studies. Be cautious of studies where processes are the primary outcome because these are of little interest to patients or their families. For example, it would be of little consolation to a family to hear that their loved one was intubated on the first pass but subsequently died.
By: Dr. Ian Stiell


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