视频与重症患者的直接喉腔镜相比:随机对照试验的更新系统审查和元分析
Beatriz Araújo1, André Rivera1, Suzany Martins1
1Department of Medicine, Nove de Julho University, 90 Dom Jaime de Barros Câmara Avenue, São Bernardo do Campo, São Paulo, Brazil.
Critical care (London, England)
|January 3, 2024
概括
与直接喉腔镜相比,视频喉腔镜 (VL) 改善了第一次试验输管成功,并减少了危急病患者的食道输管,而不是直接喉腔镜 (DL). 这些发现支持在重症监护机构中常规使用VL.
科学领域:
- 临界护理医学 临界护理医学
- 航空航道管理的管理.
- 医疗器械 医疗器械
背景情况:
- 视频喉腔镜 (VL) 在外科输管术中显示出优于直接喉腔镜 (DL) 的优势.
- 在重症监护室 (ICU) 和急诊室 (ED) 中,VL的有效性尚未得到充分证实.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),比较重症患者的VL和DL.
- 评估VL与DL在重症监护机构内内管道输入的疗效和安全性.
主要方法:
- 在PubMed,Embase,Cochrane和ClinicalTrials.gov的系统搜索RCT. 在RCT中进行系统搜索.
- 包括的研究比较了ED或ICU的成年重症患者的VL与DL.
- 使用随机效应模型进行元分析,遵循柯克兰和PRISMA指南.
主要成果:
- 对3981名患者进行的14项RCT的分析 (VL: 2002, DL: 1979).
- VL显著增加了第一次试管成功 (RR 1.12; p<0.01).
- 与DL相比,VL减少了食道输管 (RR 0.44;p<0.01) 和吸入期 (RR 0.63;p=0.03) 的发生.
结论:
- 在重症患者的输管治疗中,VL比DL更有效,更安全.
- VL增加了第一次尝试的成功率,并减少了诸如食道输管等不良事件.
- 根据目前的证据,建议在重症患者中常规使用VL.
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