Among patients in the ICU requiring intubation, video laryngoscopy compared with direct laryngoscopy did not improve first-pass orotracheal intubation rates and was associated with higher rates of severe life-threatening complications.

Further studies are needed to assess the comparative effectiveness of these 2 strategies in different clinical settings and among operators with diverse skill levels.

Among 371 randomized patients, 371 completed the trial.

The proportion of patients with successful first-pass intubation did not differ significantly between the video laryngoscopy and direct laryngoscopy groups.

The proportion of first-attempt intubations performed by nonexperts did not differ between the groups.

The median time to successful intubation was 3 minutes for both video laryngoscopy and direct laryngoscopy.

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