Suggestions for the role of video laryngoscopy as a new paradigm in airway management

摘要

We read with interest the review article by Paolini et al. in which the authors attempted to define a role for video laryngoscopy in performing classical procedural tasks, such as tracheal intubation. The authors' key issue is whether video laryngoscopy represents an additional tool to use for difficult intubation or a new paradigm for airway management.Currently, video laryngoscopic devices are mainly used in attempts to rescue difficult direct laryngoscopy (DL) procedures or as a first-line tool when a difficult laryngoscopy is anticipated. Most comparative studies of patients with an anticipated difficult tracheal intubation reveal the superiority of the video or optical devices when compared with DL. As a direct consequence, the most recent report by the American Society of Anesthesiologists' Task Force on the management of difficult airways included use of video laryngoscopes as an option to rescue a failed direct laryngoscopy when face mask ventilation is adequate or as a first-line choice when a difficult laryngoscopy is anticipated.