Positive- vs. negative-pressure extubation technique: a scoping review.

Area of Science:

• Anesthesiology and Critical Care Medicine
• Respiratory Therapy

Background:

• Positive-pressure ventilation is a common method for airway management.
• Extubation, the process of removing an endotracheal tube, requires careful management to prevent complications.

Purpose of the Study:

• To summarize recent literature on the efficacy and safety of positive-pressure extubation.
• To compare positive-pressure extubation with traditional negative-pressure techniques.

Main Methods:

• A comprehensive scoping review was conducted following the Joanna Briggs Institute framework.
• Searches were performed across multiple databases including Web of Science, PubMed, and Cochrane Library.
• Fifteen articles, encompassing 1,544 patients, were included in the final analysis.

Main Results:

• Studies reported that positive-pressure extubation effectively maintains stable vital signs (mean arterial pressure, heart rate, SpO2) and blood gas analysis indices (pH, PaO2, PaCO2).
• The technique was associated with a lower incidence of respiratory complications such as bronchospasm, laryngeal edema, and hypoxemia.
• No significant difference in safety was observed compared to traditional negative-pressure extubation.

Conclusions:

• Positive-pressure extubation is a safe and effective method for airway management.
• It offers potential advantages over traditional techniques, including improved clinical outcomes and reduced respiratory complications.
• Further research may elucidate its full clinical benefits.