Best Use of Videolaryngoscope in Intensive Care Unit

Abstract

Intubation in intensive care is a procedure burdened with significant morbidity and mortality estimated between 1 and 5%. The emergence of videolaryngoscopes — which allow an indirect glottic vision — has allowed the intensive care physicians to have an additional tool to consider an improvement in the success rate of this procedure especially in the specific case of difficult intubation. Videolaryngoscopes can be divided into three main categories: Macintosh-like videolaryngoscope, videolaryngoscope dedicated to “difficult intubation”, and videolaryngoscope “with operating channel”. Nevertheless this classic separation is called into question by the provision by manufacturers of specific blades for difficult intubation for some models. The presence of one of these devices in each critical care unit now seems critical. Nevertheless dedicated place of videolaryngoscope in each intubation is still fuzzy. The systematic use of videolaryngoscope does not make it possible to improve the success rate of this procedure, even during a procedure performed by trainees. Thus, the multiplicity of available devices must lead to a scientific and rigorous evaluation of each type of videolaryngoscope to better define the role of each device for intubation process in critical care.