Efficacy of Antichoking Suction Devices Versus Traditional Techniques: A Systematic Review and Meta-Analysis

Foreign body airway obstruction is a time-critical emergency. Traditional techniques such as back blows and abdominal thrusts are widely recommended yet may be ineffective in certain populations. Antichoking suction devices such as LifeVac and Dechoker have gained popularity in out-of-hospital settings, despite limited supporting evidence.

We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies involving humans or simulation models in which antichoking devices were used for foreign body airway obstruction management were included. Seven databases were searched. Methodological quality was assessed using the Mixed Methods Appraisal Tool and Strengthening the Reporting of Observational Studies in Epidemiology. A meta-analysis of proportions was performed to estimate airway clearance success rates, and subgroup analyses were conducted by device and study model (human vs manikin).

Six studies (n = 789) met the inclusion criteria. The overall success rate for airway clearance was 92.26%. LifeVac had the highest success rate (97.79%) and lowest heterogeneity (I² = 34.2%), followed by Dechoker (94.82%; I² = 80.4%) and the Heimlich maneuver (71.11%; I² > 80%). Studies using human subjects showed slightly higher success and lower variability than manikin-based studies. A mean of 2 attempts per device was needed. However, high heterogeneity and potential publication bias were noted.

Antichoking devices may be useful in selected scenarios, but their comparative effectiveness remains unproven. Current evidence is limited and affected by bias. Traditional techniques should remain the priority in airway obstruction management. Further independent, high-quality research is needed to clarify the clinical value of antichoking devices.