Videolaryngoscopy for airway management during the COVID–19 pandemic

Abstract

Introduction: At the end of 2019, cases of atypical pneumonia were reported in Wuhan caused by a new coronavirus. Endotracheal intubation may cause contamination of healthcare personnel. According to recent guidelines, videolaryngoscopy is preferred, because it increases the chances of intubation and avoids close contact with the patient.

Objectives: To describe airway management with videolaryngoscopy in patients with COVID-19 and to identify the main complications that appeared during endotracheal intubation.

Methods: A descriptive and cross-sectional study was carried out, in the period from December 2020 to February 2021, at the Naval Medical Center in Mexico City. The universe consisted of 178 patients with COVID-19 who required endotracheal intubation. A sample of 103 patients was taken, who were cared for by Cuban doctors.

Results: Patients older than 60 years represented 63.1% of the cases, while the male sex represented 65%. 42.1% had one predictor of difficult airway and 30.1% had two or more predictors. The glottis was visualized fully in 39.8% of cases and partially in 57.3%. Intubation on the first attempt was achieved in 73.8%. The main complications found were desaturation (33%) and arterial hypotension (37.9%).

Conclusions: Videolaryngoscopy could improve visualization of the glottic opening and endotracheal intubation on the first attempt. Desaturation and hypotension were complications that could be expected in COVID-19 patients during this procedure.

Keywords: videolaryngoscopy; endotracheal intubation; COVID-19; SARS-CoV-2.