Need to Exchange a Tracheal Tube? Use Video Laryngoscopy

Endotracheal tube (ETT) exchange is required when ventilation is ineffective because of either cuff failure or tube size. The procedure is often performed over an airway exchange catheter and, although straightforward, may be complicated by hypoxemia, esophageal intubation, or failure to reintubate. Laryngoscopy can facilitate successful ETT exchange by allowing pre-exchange airway evaluation and easier tube passage, by opening a channel to the glottic inlet. It is not known whether video laryngoscopy is superior to direct laryngoscopy in this role.

Using a single center's ETT exchange database, investigators compared success rates and complications between 328 intensive care unit patients who underwent ETT exchange over an airway exchange c…