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

IF 2.9 3区医学 Q3 ENGINEERING, BIOMEDICAL

Expert Review of Medical Devices Pub Date : 2024-04-24 DOI:10.1080/17434440.2024.2344667

J. Sastre, M. Gómez-Ríos, Teresa López, U. Gutiérrez-Couto, Rubén Casans-Francés

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引用次数: 0

Abstract

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.

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在模拟或真实场景中使用直接或间接喉镜进行气管插管时的动态和标准布吉：系统综述和荟萃分析。

方法我们检索了 2023 年 10 月 10 日的 MEDLINE、Embase、CENTRAL、Web of Science、Scopus 和 Google Scholar。我们纳入了对两种设备进行比较的临床试验。主要结果是首次尝试插管的成功率。结果共纳入 18 项研究。在人体临床试验中，动态缓冲器不会提高首次尝试成功率（RR 1.11；P = 0.06）或缩短气管插管时间（MD -0.30秒；P = 0.84）。在困难气道中，首次尝试成功插管率更高的是动态弹力袜（RR 1.17；p = 0.002）；此外，动态弹力袜还缩短了插管所需的时间（MD -4.80 秒；p = 0.001）。首次尝试插管成功率更高（RR 1.15；p = 0.01），使用 Macintosh 刀片和动态弹弓时，插管时间更短（MD -5.38 秒；p < 0.00001）。结论动态推杆并不能提高总的首次插管成功率或缩短气管插管时间。但是，对于困难气道患者和使用 Macintosh 刀插管的患者，动态推杆似乎能提高首次尝试气管插管的成功率。要得出确切结论，还需要进一步研究。

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来源期刊

Expert Review of Medical Devices 医学-工程：生物医学

CiteScore

5.90

自引率

3.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal serves the device research community by providing a comprehensive body of high-quality information from leading experts, all subject to rigorous peer review. The Expert Review format is specially structured to optimize the value of the information to reader. Comprehensive coverage by each author in a key area of research or clinical practice is augmented by the following sections: Expert commentary - a personal view on the most effective or promising strategies Five-year view - a clear perspective of future prospects within a realistic timescale Key issues - an executive summary cutting to the author''s most critical points In addition to the Review program, each issue also features Medical Device Profiles - objective assessments of specific devices in development or clinical use to help inform clinical practice. There are also Perspectives - overviews highlighting areas of current debate and controversy, together with reports from the conference scene and invited Editorials.