The Application Effect of Video Laryngoscopy in Tracheal Intubation in Critically Ill Patients

Background: Endotracheal intubation (TI) is a critical procedure in emergency airway management. While, direct laryngoscopy (DL) is widely used and video laryngoscopy (VL) enhances visualization and may improve intubation success and safety. Objective: This study aimed to compare VL and DL in critically ill patients requiring emergency intubation, evaluating efficacy, success rates, and complications. Patients and methods:A prospective observational study was conducted in the ICU at Benha University Hospital. Patients aged ≥18 years requiring emergency intubation were randomized into VL (n=55) or DL (n=55) groups. Primary outcomes included first-pass success, intubation time, glottic visualization (POGO score), and complication rates. Results:VL significantly improved glottic visualization (POGO: 80.44% vs. 54.18%, p < 0.001), first-pass success (83.64% vs. 63.64%, p=0.017), and reduced intubation time (36.02s vs. 40.91s, p < 0.001). Fewer intubation attempts were required (p=0.032). VL was associated with a lower airway injury rate (3.64% vs. 16.36%, p=0.026) and overall complication rate (12.73% vs. 30.91%, p=0.021), with no significant differences in hemodynamic stability. Conclusion:VL improves intubation efficiency, enhances first-pass success, and reduces complications compared to DL in critically ill patients. These findings support its integration into emergency airway management protocols.