Tracheal tube introducer-associated airway trauma: a systematic review

被引:4
作者
Boulton, Adam J. [1 ,2 ]
Smith, Edward [1 ]
Yasin, Ambreen [1 ]
Moreton, Joseph [2 ]
Mendonca, Cyprian [1 ,2 ]
机构
[1] Univ Hosp Coventry & Warwickshire NHS Trust, Dept Anaesthesia, Coventry, England
[2] Univ Warwick, Warwick Med Sch, Warwick Clin Trials Unit, Coventry, England
关键词
airway catheter; bougie; tracheal intubation; stylet; videolaryngoscopy; ENDOTRACHEAL INTUBATION; NASOTRACHEAL INTUBATION; DIFFICULT INTUBATION; 1ST-ATTEMPT SUCCESS; DIRECT LARYNGOSCOPY; VIDEO-STYLET; BOUGIE; MANAGEMENT; VIDEOLARYNGOSCOPY; COMPLICATIONS;
D O I
10.1111/anae.16379
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
BackgroundTracheal tube introducers are recommended in airway management guidelines and are used increasingly as videolaryngoscopy becomes more widespread. This systematic review aimed to summarise the published literature concerning tracheal tube introducer-associated airway trauma.MethodsPubMed, EMBASE and CINAHL databases were searched using pre-determined criteria. Two authors independently assessed search results and performed data extraction and risk of bias assessments.ResultsWe included 16 randomised controlled trials and five observational studies involving 10,797 patients. There was heterogeneity in patient characteristics, airway manipulation, and airway trauma definition and measurement. One study investigated hyperangulated videolaryngoscopy. The standard stylet was the most commonly reported introducer, followed by bougie and stylets with additional features such as video or lighted tip. Airway trauma resulted in low harm and most frequently involved injuries to the upper airway, followed by laryngeal and tracheobronchial injuries. Eighteen studies were comparative and reported a reduction in airway trauma incidence when an introducer was used, with the exception of the standard stylet. Median (IQR [range]) pooled incidence of airway trauma associated with standard stylets was 13.1% (4.2-31.4 [0.5-79.2])% and with bougies was 5.4% (0.4-49.9 [0.0-68.0])%. The risk of bias of included studies was variable and many randomised trials were found to be at high risk due to non-robust measurement of the outcome.ConclusionsStylets might be associated with an increased risk of airway trauma compared with other devices or when no stylet was used, though the quality of evidence is modest. However, other introducers appear to be safe and reduce the risk of airway trauma.
引用
收藏
页码:1091 / 1101
页数:11
相关论文
共 66 条
[11]   The High-Risk Airway [J].
Cabrera, Jorge L. ;
Auerbach, Jonathan S. ;
Merelman, Andrew H. ;
Levitan, Richard M. .
EMERGENCY MEDICINE CLINICS OF NORTH AMERICA, 2020, 38 (02) :401-+
[12]   Updates in emergency airway management [J].
Carlson, Jestin N. ;
Wang, Henry E. .
CURRENT OPINION IN CRITICAL CARE, 2018, 24 (06) :525-530
[13]   Strategies for the prevention of airway complications - a narrative review [J].
Cook, T. M. .
ANAESTHESIA, 2018, 73 (01) :93-111
[14]   Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia [J].
Cook, T. M. ;
Woodall, N. ;
Frerk, C. .
BRITISH JOURNAL OF ANAESTHESIA, 2011, 106 (05) :617-631
[15]   Has the time really come for universal videolaryngoscopy? [J].
Cook, Tim M. ;
Aziz, Michael F. .
BRITISH JOURNAL OF ANAESTHESIA, 2022, 129 (04) :474-477
[16]   Universal videolaryngoscopy: the importance of choosing the right device. Reply to 'Cognitive re-engineering after a 15-year experience with routine videolaryngoscopy' (Br J Anaesth 2019; 122: e57-8) [J].
Cook, Tim M. ;
Kelly, Fiona E. ;
Boniface, Nancy ;
Seller, Chris .
BRITISH JOURNAL OF ANAESTHESIA, 2019, 122 (03) :E59-E60
[17]   Airway rescue in acute upper airway obstruction using a ProSeal™ Laryngeal mask airway and an Aintree Catheter™:: a review of the ProSeal™ Laryngeal mask airway in the management of the difficult airway [J].
Cook, TM ;
Silsby, J ;
Simpson, TP .
ANAESTHESIA, 2005, 60 (11) :1129-1136
[18]  
de Almeida JP, 2013, REV BRAS ANESTESIOL, V63, P107, DOI [10.1016/S0034-7094(13)70202-2, 10.1016/j.bjane.2012.02.001]
[19]   SUCCESSFUL DIFFICULT INTUBATION - TRACHEAL TUBE PLACEMENT OVER A GUM-ELASTIC BOUGIE [J].
DOGRA, S ;
FALCONER, R ;
LATTO, IP .
ANAESTHESIA, 1990, 45 (09) :774-776
[20]   The Bougie and First-Pass Success in the Emergency Department [J].
Driver, Brian ;
Dodd, Kenneth ;
Klein, Lauren R. ;
Buckley, Ryan ;
Robinson, Aaron ;
McGill, John W. ;
Reardon, Robert F. ;
Prekker, Matthew E. .
ANNALS OF EMERGENCY MEDICINE, 2017, 70 (04) :473-478