Comparison of video-stylet and conventional laryngoscope for endotracheal intubation in adults with cervical spine immobilization: A PRISMA-compliant meta-analysis.
Medicine (Baltimore)
; 101(33): e30032, 2022 Aug 19.
Article
em En
| MEDLINE
| ID: mdl-35984197
ABSTRACT
BACKGROUND:
Although minimization of cervical spine motion by using a neck collar or manual in-line stabilization is recommended for urgent tracheal intubation (TI) in patients with known or suspected cervical spine injury (CSI), it may worsen glottic visualization. The overall performance of video-stylets during TI in patients with neck immobilization remains unclear. The current meta-analysis aimed at comparing the intubation outcomes of different video-stylets with those of conventional laryngoscopes in patients with cervical immobilization.METHOD:
The databases of Embase, Medline, and the Cochrane Central Register of Controlled Trials were searched from inception to June 2021 to identify trials comparing intubation outcomes between video-stylets and conventional laryngoscopes. The primary outcome was first-pass success rate, while secondary outcomes included overall success rate, time to intubation, the risk of intubation-associated sore throat, or tissue damage.RESULTS:
Five randomized controlled trials published between 2007 and 2013 involving 487 participants, all in an operating room setting, were analyzed. The video-stylets investigated included Bonfils intubation fiberscope, Levitan FPS Scope, and Shikani optical stylet. There was no difference in first-pass success rate (risk ratio [RR] =1.08, 95% confidence interval [CI] 0.89-1.31, P = .46], overall success rate (RR = 1.06, 95% CI 0.93-1.22, P = .4), intubation time [mean difference = 4.53 seconds, 95% CI -8.45 to 17.51, P = .49), and risk of tissue damage (RR = 0.46, 95% CI 0.16-1.3, P = .14) between the 2 groups. The risk of sore throat was lower with video-stylets compared to that with laryngoscopes (RR = 0.45, 95% CI 0.23-0.9, P = .02).CONCLUSION:
Our results did not support the use of video-stylets as the first choice for patients with neck immobilization. Further studies are required to verify the efficacy of video-stylets in the nonoperating room setting.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Faringite
/
Laringoscópios
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Systematic_reviews
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Medicine (Baltimore)
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Taiwan