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视频喉镜检查与纤维支气管镜分别用于清醒插管的比较 - 随机对照试验的系统评价和荟萃分析

 

Authors Jiang J, Ma DX, Li B, Wu AS, Xue FS

Received 1 May 2018

Accepted for publication 27 June 2018

Published 15 October 2018 Volume 2018:14 Pages 1955—1963

DOI https://doi.org/10.2147/TCRM.S172783

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang

Background: Awake intubation with videolaryngoscopy (VL) is a novel method that is drawing more and more attention as an alternative to awake intubation with fiberoptic bronchoscope (FOB). This meta-analysis is designed to determine the performance of VL compared to the FOB for awake intubation.
Methods: The Cochrane Central Register of Controlled Trials, PubMed, Embase, and Web of science were searched from database inception until October 30, 2017. Randomized controlled trials comparing VL and FOB for awake intubation were selected. The primary outcome was the overall success rate. Rev-Man 5.3 software was used to perform the pooled analysis and assess the risk of bias for each eligible study. The GRADE system was used to assess the quality of evidence for all outcomes.
Results: Six studies (446 patients) were included in the review for data extraction. Pooled analysis did not show any difference in the overall success rate by using VL and FOB (relative risk [RR], 1.00; =0.99; high-quality evidence). There was no heterogeneity among studies (2=0). Subgroup analyses showed no differences between two groups through nasal (RR, 1.00; =1.00; high-quality evidence) and oral intubations (RR, 1.00; =0.98; high-quality evidence). The intubation time was shorter by using VL than by using FOB (mean difference, -40.4 seconds; <0.01; low-quality evidence). There were no differences between groups for other outcomes (>0.05).
Conclusion: For awake intubation, VL with a shorter intubation time is as effective and safe as FOB. VL may be a useful alternative to FOB.
Keywords: airway management, awake intubation, videolaryngoscopy, fiberoptic bronchoscopy, randomized controlled clinical trials, outcomes




Figure 2 Risk of bias summary: review authors’ judgements about...