title: Endotracheal intubation using videolaryngoscopy causes less cardiovascular response compared to classic direct laryngoscopy, in cardiac patients according a standard hospital protocol.
abstract: BACKGROUND
  Previous studies comparing Glidescope and classic direct laryngoscopy did not show an attenuation of CV responses to endotracheal intubation. In the present study, we hypothesize that indirect videolaryngoscopy can attenuate cardiovascular responses to endotracheal intubation.
  
  
  METHODS
  In a randomized cross-over study, eighty adults (ASA PS II-III) were included. Both direct and indirect videolaryngoscopies were used in a random order, in the same patient. Cardiovascular responses to intubation were recorded as a relative change in rate pressure product (RPP = systolic blood pressure times heart rate) from baseline values. A linear mixed model was used to study the association between the outcome variable RPP and the type of laryngoscope used.
  
  
  RESULTS
  The relative increase of the RPP at intubation was significantly smaller (i.e. 27%, P < 0.001) using videolaryngoscopy compared to the classic direct laryngoscopy. Cardiovascular responses were blunted by an additional 10.2% (P = 0.029), when the patient was on beta blockade.
  
  
  CONCLUSIONS
  Our study shows less hemodynamic responses during endotracheal intubation using indirect videolaryngoscopy compared to classic direct laryngoscopy.
authors.affiliation: Department of Anaesthesiology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: R L J G
authors.initials: RL
authors.lastname: Maassen
authors.forename: B M A
authors.initials: BM
authors.lastname: Pieters
authors.forename: B
authors.initials: B
authors.lastname: Maathuis
authors.forename: J
authors.initials: J
authors.lastname: Serroyen
authors.forename: M A E
authors.initials: MA
authors.lastname: Marcus
authors.forename: P
authors.initials: P
authors.lastname: Wouters
authors.forename: A A J
authors.initials: AA
authors.lastname: van Zundert
mesh_terms: D000368:Aged; D001794:Blood Pressure; D018592:Cross-Over Studies; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D014743:Videotape Recording