Dynamic versus standard bougies for tracheal intubation with direct or indirect laryngoscopy in simulated or real scenarios: a systematic review and meta-analysis.

INTRODUCTION: This systematic review and meta-analysis aimed to compare the efficacy of dynamic versus standard bougies to achieve tracheal intubation. METHODS: We searched MEDLINE, Embase, CENTRAL, Web of Science, Scopus and Google Scholar on 10 October 2023. We included clinical trials comparing both devices. The primary outcome was the first-attempt intubation success rate. The secondary outcome was the time required for tracheal intubation. RESULTS: Eighteen studies were included. Dynamic bougies do not increase first-attempt success rate (RR 1.11; p = 0.06) or shorten tracheal intubation time (MD -0.30 sec; p = 0.84) in clinical trials in humans. In difficult airways, first-attempt success intubation rate was greater for dynamic bougies (RR 1.17; p = 0.002); Additionally, they reduced the time required for intubation (MD -4.80 sec; p = 0.001). First-attempt intubation success rate was higher (RR 1.15; p = 0.01) and time to achieve intubation was shorter when using Macintosh blades combined with dynamic bougies (MD -5.38 sec; p < 0.00001). Heterogeneity was high. CONCLUSION: Dynamic bougies do not increase the overall first-pass success rate or shorten tracheal intubation time. However, dynamic bougies seem to improve first-attempt tracheal intubation rate in patients with difficult airways and in those intubated with a Macintosh blade. Further research is needed for definitive conclusions. REGISTRATION OF PROSPERO: CRD42023472122.

Executive Summary of the Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR) Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) Guideline for difficult airway management.

The Airway section of the Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) present the Guidelines for the integral management of difficult airway in adult patients. This document provides recommendations based on current scientific evidence, theoretical-educational tools and implementation tools, mainly cognitive aids, applicable to the treatment of the airway in the field of anesthesiology, critical care, emergencies and prehospital medicine. Its principles are focused on the human factors, cognitive processes for decision-making in critical situations and optimization in the progression of the application of strategies to preserve adequate alveolar oxygenation in order to improve safety and quality of care.

[Readability of health web pages for patients and readers among the general population]. / Legibilidad de las páginas web sobre salud dirigidas a pacientes y lectores de la población general.

BACKGROUND: Internet is becoming now becoming one of the major healthcare information sources. Aside from this popularity, new questions are now coming to bear, such as the quality of the information provided or its ability to convey knowledge. The purpose of this study is that of gauging the degree of readability of this information for patients which is accessible on the Internet in Spanish. METHODS: A total of 112 webpages dealing with seven (7) chronic diseases were selected. Based on the Microsoft Word readability statistics, we recovered the data of the number of syllables and sentences in the first 100 words in each document. For calculating readability, we used the adaptation of the Flesch degree formula for the Spanish language devised by Fernández Huerta. RESULTS: The mean readability of the documents is 65.16 (+/- 14.75), thus corresponding to a standard level, in other words, a thirteen-year-old's reading level. CONCLUSIONS: Although the readability scores found for the documents analyzed are good, they are not optimum for the users searching for health-related information on the Internet. It is essential that these informative documents be adapted to these users' readability level.. The need for studies evaluating the consequences entailed in the low degree of health-related literacy entails the incorrect use of medications, mistakes in preparing for diagnostic tests and an increase in the costs of healthcare services.