{"id":24275,"date":"2023-07-02T04:16:00","date_gmt":"2023-07-01T20:16:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24275"},"modified":"2023-07-02T06:30:26","modified_gmt":"2023-07-01T22:30:26","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%87%87%e7%94%a8%e8%a7%86%e9%a2%91%e5%96%89%e9%95%9c%e6%88%96%e7%9b%b4%e6%8e%a5%e5%96%89%e9%95%9c%e8%bf%9b%e8%a1%8c%e5%8d%b1%e9%87%8d%e7%97%85","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24275","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u91c7\u7528\u89c6\u9891\u5589\u955c\u6216\u76f4\u63a5\u5589\u955c\u8fdb\u884c\u5371\u91cd\u75c5\u60a3\u8005\u7684\u6c14\u7ba1\u63d2\u7ba1"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults<\/h1>\n\n\n\n

Matthew E. Prekker, Brian E. Driver, Stacy A. Trent,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med June 16, 2023
DOI: 10.1056\/NEJMoa2301601<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h2>\n\n\n\n

Whether video laryngoscopy as compared with direct laryngoscopy increases the likelihood of successful tracheal intubation on the first attempt among critically ill adults is uncertain.<\/p>\n\n\n\n

METHODS<\/h2>\n\n\n\n

In a multicenter, randomized trial conducted at 17 emergency departments and intensive care units (ICUs), we randomly assigned critically ill adults undergoing tracheal intubation to the video-laryngoscope group or the direct-laryngoscope group. The primary outcome was successful intubation on the first attempt. The secondary outcome was the occurrence of severe complications during intubation; severe complications were defined as severe hypoxemia, severe hypotension, new or increased vasopressor use, cardiac arrest, or death.<\/p>\n\n\n\n

RESULTS<\/h2>\n\n\n\n

The trial was stopped for efficacy at the time of the single preplanned interim analysis. Among 1417 patients who were included in the final analysis (91.5% of whom underwent intubation that was performed by an emergency medicine resident or a critical care fellow), successful intubation on the first attempt occurred in 600 of the 705 patients (85.1%) in the video-laryngoscope group and in 504 of the 712 patients (70.8%) in the direct-laryngoscope group (absolute risk difference, 14.3 percentage points; 95% confidence interval [CI], 9.9 to 18.7; P<0.001). A total of 151 patients (21.4%) in the video-laryngoscope group and 149 patients (20.9%) in the direct-laryngoscope group had a severe complication during intubation (absolute risk difference, 0.5 percentage points; 95% CI, \u22123.9 to 4.9). Safety outcomes, including esophageal intubation, injury to the teeth, and aspiration, were similar in the two groups.<\/p>\n\n\n\n

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CONCLUSIONS<\/h2>\n\n\n\n

Among critically ill adults undergoing tracheal intubation in an emergency department or ICU, the use of a video laryngoscope resulted in a higher incidence of successful intubation on the first attempt than the use of a direct laryngoscope. (Funded by the U.S. Department of Defense; DEVICE ClinicalTrials.gov number, NCT05239195. opens in new tab<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Video versus Direct Laryngoscopy for T […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24275"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24275"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24275\/revisions"}],"predecessor-version":[{"id":24276,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24275\/revisions\/24276"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24275"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24275"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24275"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}