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Video laryngoscopy edges out direct in kids

Video laryngoscopy versus direct laryngoscopy for pediatric emergency tracheal intubation: a systematic review and meta-analysis
Resuscitation Plus · 2026-10 · Added 9 October 2026

A systematic review and meta-analysis of 18 studies (17 observational, 1 RCT) found video laryngoscopy for paediatric emergency intubation was associated with higher first-pass success (RR 1.11) and fewer severe adverse events (RR 0.76), on very low certainty evidence.

Study type

Systematic review

Design

Systematic review and meta-analysis (PROSPERO-registered, GRADE)

Participants

18 studies (17 observational, 1 RCT) in paediatric acute care

Main finding

First-pass success 72.2% vs 69.0% with direct laryngoscopy (RR 1.11, 95% CI 1.06–1.16); severe intubation-associated events 7.7% vs 11.8% (RR 0.76, 95% CI 0.62–0.93); overall success and desaturation similar; no survival or cardiac arrest data

Caveat

Very low certainty evidence dominated by observational studies, with no data on survival or cardiac arrest

Bottom line

Hypothesis-generating

Learning goal

Weigh the benefits and limitations of video laryngoscopy over direct laryngoscopy for paediatric emergency intubation in my practice.

More

• Topic: Airway & ventilation
• Daily scan: 9 October 2026

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