Abstract
Intubation is frequently required for patients in the intensive care unit (ICU) but is associated with high morbidityand mortality mainly in emergency procedures and in the presence of severe organ failures. Improving theintubation procedure is a major goal for all ICU physicians worldwide, and videolaryngoscopy may play a relevant role.Videolaryngoscopes are a heterogeneous entity, including Macintosh blade-shaped optical laryngoscopes, anatomicallyshaped blade without a tube guide and anatomically shaped blade with a tube guide, which might have theoreticalbenefits and pitfalls. Videolaryngoscope/videolaryngoscopy improves glottis view and allows supervision by an expertduring the intubation process; however, randomized controlled trials in the ICU suggest that the systematic use ofvideolaryngoscopes for every intubation cannot yet be recommended, especially in non-expert hands. Nevertheless, avideolaryngoscope should be available in all ICUs as a powerful tool to rescue difficult intubation or unsuccessful first-pass laryngoscopy, especially in expert hands.The use of associated devices such as bougie or stylet, glottis view needed (full vs incomplete) and patient positionduring intubation (ramped, sniffed position) should be further evaluated. Future trials will better define the role ofvideolaryngoscopy in ICU.