Videolaryngoscopy vs. direct laryngoscopy in orotracheal intubation in obese critical patients: Systematic review and meta-analysis

Gil-Bazán S.D.; Vásquez-Tirado G.A.; Chávez-Cruzado E.; Meregildo-Rodríguez E.D.; Quispe-Castañeda C.V.; Guzmán-Aguilar W.M.; Liñán-Díaz L.J. · Medicina Intensiva (2025) · DOI: 10.1016/j.medin.2025.502168

Resumen

Objective To determine whether the use of videolaryngoscopy (VL) is more effective than direct laryngoscopy (DL) for orotracheal intubation in obese patients. Design This is a systematic review and meta-analysis. Setting A comprehensive search was conducted in five databases for studies published up to December 26, 2023, using a PICO strategy. Fifteen studies were identified for quantitative analysis and included in our meta-analysis. Participants The participants of the included primary studies (obese patients). Interventions Orotracheal intubation with videolaryngoscopy or direct laryngoscopy. Main variables of interest Videolaryngoscopy, direct laryngoscopy, intubation time, first--pass success rate, minor complications. Results No significant differences were found in intubation time between VL and DL in obese patients (MD: −4.84; 95% CI: −13.49 to 3.80; I2: 90%). In the subgroup analysis, the Airtaq technique showed a significant difference in intubation time compared to the Macintosh technique (MD: −25.29; 95% CI: −49.17 to −1.38; I2: 95%). However, no significant differences were observed in the first--pass success rate (OR: 1.58; 95% CI: 0.77–3.23; I2: 33%) or in complications such as pain (OR: 1.15; 95% CI: 0.75–1.75; I2: 0%) and voice changes (OR: 0.76; 95% CI: 0.46–1.26; I2: 0%) between the two methods. Conclusion There are no significant differences in intubation time, first--pass success rate, or complications between VL and DL in obese critical patients.

Instituciones: Universidad Privada Antenor Orrego; Universidad Señor de Sipán