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.