Comparative effectiveness of ultrasound-guided and anatomic landmark percutaneous dilatational tracheostomy: A systematic review and meta-analysis.
PLoS One
; 16(10): e0258972, 2021.
Article
en En
| MEDLINE
| ID: mdl-34710141
ABSTRACT
INTRODUCTION:
Ultrasound-guided tracheostomy (UGT) and bronchoscope-guided tracheostomy (BGT) have been well compared. However, the differences in benefits between UGT and landmark tracheostomy (LT) have not been addressed and, in particular, lack a detailed meta-analysis. We aimed to compare the first-pass success, complication rate, major bleeding rate, and tracheostomy procedure time between UGT and LT.METHODS:
In a systematic review, relevant databases were searched for studies comparing UGT with LT in intubated patients. The primary outcome was the odds ratio (OR) of first-pass success. The secondary outcomes were the OR of complications, OR of major bleeding, and standardized mean difference (SMD) of the total tracheostomy procedure time.RESULTS:
The meta-analysis included three randomized controlled studies (RCTs) and one nonrandomized controlled study (NRS), comprising 474 patients in total. Compared with LT, UGT increased first-pass success (OR 4.287; 95% confidence interval [CI] 2.308 to 7.964) and decreased complications (OR 0.422; 95% CI 0.249 to 0.718). However, compared with LT, UGT did not significantly reduce major bleeding (OR 0.374; 95% CI 0.112 to 1.251) or the total tracheostomy placement time (SMD -0.335; 95% CI -0.842 to 0.172).CONCLUSIONS:
Compared with LT, real-time UGT increases first-pass success and decreases complications. However, UGT was not associated with a significant reduction in the major bleeding rate. The total tracheostomy placement time comparison between UGI and LT was inconclusive.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Broncoscopía
/
Traqueostomía
/
Ultrasonografía Intervencional
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
PLoS One
Asunto de la revista:
CIENCIA
/
MEDICINA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Taiwán