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As video laryngoscope (VL) use has increased in the operating room, it also has become more common in the intensive care unit (ICU). Intubations in the ICU generally are higher risk, with patients commonly hypoxemic and often at high risk for aspiration. Despite a perception that VL could make ICU intubations safer, small studies have suggested that VL engenders longer procedure times and higher mortality.
French investigators randomized 371 ICU patients who required urgent intubation to either video or direct laryngoscopy (DL). The process for intubation was standardized for preoxygenation and medications. Most intubations (84%) were done by nonexperts (residents). First-pass intubation rates overall were similar for VL and DL (68% and 70%)…