Direct Laryngoscopy Versus Video Laryngoscopy for… : Critical Care Medicine
U patients. DATA SOURCES: We searched MEDLINE, PubMed, Embase, Cochrane Library, and unpublished sources, from inception to February 27, 2024. STUDY SELECTION: We included randomized controlled trials (RCTs) of critically ill adult patients randomized to VL compared with DL for endotracheal intubation. DATA EXTRACTION: Reviewers screened abstracts, full texts, and extracted data independently and in duplicate. We pooled data using a random-effects model, assessed risk of bias using the modified Cochrane tool and certainty of evidence using the Grading Recommendations Assessment, Development, and Evaluation approach. We pre-registered the protocol on PROSPERO (CRD42023469945). DATA SYNTHESIS: We included 20 RCTs (n = 4569 patients). Compared with DL, VL probably increases first pass success (FPS) (relative risk [RR], 1.13; 95% CI, 1.06–1.21; moderate certainty) and probably decreases esophageal intubations (RR, 0.47; 95% CI, 0.27–0.82; moderate certainty). VL may result in fewer aspirat