Schulich School of Medicine and Dentistry, London, Ontario, Canada
Schulich School of Medicine and Dentistry, London, Ontario, Canada.
BMJ Open. 2022 Nov 4;12(11):e062988. doi: 10.1136/bmjopen-2022-062988.
Rapid sequence intubation (RSI) is an advanced airway technique to perform endotracheal intubation in patients at high risk of aspiration. Although RSI is recognised as a life-saving technique and performed by many physicians in various settings (emergency departments, intensive care units), there is still a lack of consensus on various features of the procedure, most notably patient positioning. Previously, experts have commented on the unique drawbacks and benefits of various positions and studies have been published comparing patient positions and how it can affect endotracheal intubation in the context of RSI. The purpose of this systematic review is to compile the existing evidence to understand and compare how different patient positions can potentially affect the success of RSI.
We will use MEDLINE, EMBASE and the Cochrane Library to source studies from 1946 to 2021 that evaluate the impact of patient positioning on endotracheal intubation in the context of RSI. We will include randomised control trials, case-control studies, prospective/retrospective cohort studies and mannequin simulation studies for consideration in this systematic review. Subsequently, we will generate a Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram to display how we selected our final studies for inclusion in the review. Two independent reviewers will complete the study screening, selection and extraction, with a third reviewer available to address any conflicts. The reviewers will extract this data in accordance with our outcomes of interest and display it in a table format to highlight patient-relevant outcomes and difficulty airway management outcomes. We will use the Risk of Bias tool and the Newcastle-Ottawa Scale to assess included studies for bias.
This systematic review does not require ethics approval, as all patient-centred data will be reported from published studies.
CRD42022289773.
快速序贯插管（RSI）是一种在有高误吸风险的患者中进行经气管插管的高级气道技术。尽管 RSI 被认为是一种救生技术，并且在各种环境（急诊科、重症监护病房）中由许多医生执行，但在该程序的各个方面仍缺乏共识，尤其是患者体位。以前，专家们曾对各种体位的独特优缺点发表过评论，并且已经发表了一些研究比较了患者体位以及在 RSI 背景下它如何影响气管插管。本系统评价的目的是汇编现有证据，以了解和比较不同患者体位如何潜在地影响 RSI 的成功率。
我们将使用 MEDLINE、EMBASE 和 Cochrane 图书馆从 1946 年至 2021 年的研究中寻找评估 RSI 中患者体位对气管插管影响的研究。我们将包括随机对照试验、病例对照研究、前瞻性/回顾性队列研究和模拟人体研究以供本系统评价考虑。随后，我们将生成 PRISMA 流程图以显示我们如何选择最终纳入审查的研究。两名独立的审查员将完成研究筛选、选择和提取，第三名审查员可解决任何冲突。审查员将根据我们感兴趣的结果提取这些数据并以表格形式显示，以突出患者相关结果和困难气道管理结果。我们将使用偏倚风险工具和纽卡斯尔-渥太华量表评估纳入研究的偏倚。
本系统评价不需要伦理批准，因为所有以患者为中心的数据都将从已发表的研究中报告。
PROSPERO 注册号：CRD42022289773。
