Aggarwal A, Mustahsin M, Shishir P. Comparison of intubating laryngeal mask airway and video laryngoscope during emergency intubation in patients who are critically ill. World J Crit Care Med 2026; 15(1): 112345 [DOI: 10.5492/wjccm.v15.i1.112345]
Corresponding Author of This Article
Mohd Mustahsin, DM, MD, Associate Professor, Head, Division of Critical Care Medicine, Department of Anaesthesiology and Critical Care, Era University, FFF-2, Doctor’s Residence, Hardoi Road, Sarfarazganj, Lucknow 226003, Uttar Pradesh, India. mustahsin.malik@gmail.com
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Critical Care Medicine
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Randomized Controlled Trial
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Mar 9, 2026 (publication date) through Mar 3, 2026
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World Journal of Critical Care Medicine
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2220-3141
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Aggarwal A, Mustahsin M, Shishir P. Comparison of intubating laryngeal mask airway and video laryngoscope during emergency intubation in patients who are critically ill. World J Crit Care Med 2026; 15(1): 112345 [DOI: 10.5492/wjccm.v15.i1.112345]
World J Crit Care Med. Mar 9, 2026; 15(1): 112345 Published online Mar 9, 2026. doi: 10.5492/wjccm.v15.i1.112345
Comparison of intubating laryngeal mask airway and video laryngoscope during emergency intubation in patients who are critically ill
Apurva Aggarwal, Mohd Mustahsin, Piyush Shishir
Apurva Aggarwal, Critical Care Unit, Department of Anaesthesiology and Critical Care, Era University, Lucknow 226003, Uttar Pradesh, India
Mohd Mustahsin, Division of Critical Care Medicine, Department of Anaesthesiology and Critical Care, Era University, Lucknow 226003, Uttar Pradesh, India
Piyush Shishir, Department of Anaesthesiology, Era University, Lucknow 226003, Uttar Pradesh, India
Author contributions: Aggarwal A collected the patients’ data; Mustahsin M designed the study, analyzed the data, and wrote and revised the paper; Shishir P performed the statistical analysis; all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the Era’s Lucknow Medical College and Hospital, Lucknow (No. ELMC&H/R-Cell/2023/08).
Clinical trial registration statement: This study is registered at Clinical Trial Registry-India, No. CTRI/2024/02/062697.
Informed consent statement: All study participants, or their legal guardian, provided written informed consent before enrollment in this study.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: There are no additional data to share.
Corresponding author: Mohd Mustahsin, DM, MD, Associate Professor, Head, Division of Critical Care Medicine, Department of Anaesthesiology and Critical Care, Era University, FFF-2, Doctor’s Residence, Hardoi Road, Sarfarazganj, Lucknow 226003, Uttar Pradesh, India. mustahsin.malik@gmail.com
Received: July 24, 2025 Revised: August 15, 2025 Accepted: November 13, 2025 Published online: March 9, 2026 Processing time: 219 Days and 18 Hours
Abstract
BACKGROUND
Emergency endotracheal intubation is a high-risk procedure in patients who are critically ill and associated with complications such as hypoxia, hemodynamic instability, and airway trauma. The intubating laryngeal mask airway (ILMA) and video laryngoscope (VL) are alternative devices to conventional direct laryngoscopy, but their comparative efficacy in emergency settings remains understudied.
AIM
To compare the first-attempt success rate, intubation time, hemodynamic response, and complications between ILMA and VL in emergency intubations.
METHODS
A prospective randomized study was conducted on 64 patients who were critically ill and requiring emergency intubation. Patients were divided into the VL (n = 32) and ILMA (n = 32) groups. Primary outcomes included first-attempt success rate and intubation time. Secondary outcomes assessed hemodynamic changes (mean arterial pressure, heart rate, oxygen saturation) and complications (trauma, desaturation, sore throat).
RESULTS
The VL group had a significantly higher first-attempt success rate (87.5% vs 53.1%, P = 0.009) and shorter total intubation time (44.0 ± 19.7 seconds vs 82.5 ± 14.5 seconds, P < 0.001). Hemodynamic responses were comparable, but ILMA was associated with more complications (mouth damage: 26.9% vs 0%, P = 0.002; sore throat: 26.9% vs 3.1%, P = 0.009).
CONCLUSION
VL is superior to ILMA for emergency intubation, offering higher first-pass success, faster intubation, and fewer complications. VL should be prioritized in critical care settings.
Core Tip: This randomized controlled trial demonstrated video laryngoscope (VL) outperformed intubating laryngeal mask airway (ILMA) for emergency intubation in patients who were critically ill, showing significantly higher first-attempt success (87.5% vs 53.1%), faster intubation (44.0 ± 19.7 seconds vs 82.5 ± 14.5 seconds), and fewer complications. The superior visualization of VL and reduced need for adjunctive maneuvers make it the preferred first-line device for emergency airway management while ILMA remains a valuable backup option. These findings support updating critical care protocols to prioritize VL use, particularly in time-sensitive scenarios where rapid, successful intubation is crucial for patient outcomes.
