College of Medicine and Health Science, Wuhan Polytechnic University, Wuhan, 430023, Hubei, China.
Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Sci Rep. 2023 Oct 30;13(1):18626. doi: 10.1038/s41598-023-45173-5.
To evaluate the comparative efficacy and safety of different intubation devices on intubation outcomes in pediatric intubation. We identified relevant studies from previous meta-analyses and literature retrieval in PubMed, EMBASE, and Cochrane Library. The primary outcome was the first-pass success (FPS), and the secondary outcome included the time to intubation (TTI) and the risk of local complications (LC). Network meta-analysis was performed using STATA 14.0. Twenty-three randomized comparative trials (RCTs) including 12 devices were included. Compared with Macintosh, Airtraq (odds ratio [OR] = 13.05, 95% confidence interval [CI] = 4.68 to 36.38), Miller (OR = 4.77, 95%CI = 1.32 to 17.22), Glidescope (OR = 2.76, 95%CrI = 1.60 to 4.75) and McGrath (OR = 4.61, 95%CI = 1.18 to 17.99) obtained higher PFS. Meanwhile, Airtraq was superior to Glidescope (OR = 0.21, 95%CI = 0.07 to 0.65) for PFS. For TTI, Canada was superior to other intubation devices, as well as CMAC was superior to TruViewEVO2, Glidescope, and StorzDCI. Airtraq lowered the risk of LC compared with Macintosh and Pentax but there was no statistical difference between Airtraq and KingVision. Airtraq may be the optimal option for FPS, Canada for TTI, and KingVision for LC in pediatric intubation.
为了评估不同插管设备在儿科插管中插管结果的比较疗效和安全性。我们从之前的荟萃分析和文献检索中在 PubMed、EMBASE 和 Cochrane Library 中确定了相关研究。主要结局是首次通过成功率（FPS），次要结局包括插管时间（TTI）和局部并发症（LC）风险。使用 STATA 14.0 进行网络荟萃分析。纳入了 23 项随机对照试验（RCT），包括 12 种设备。与 Macintosh 相比，Airtraq（优势比[OR] = 13.05，95%置信区间[CI] = 4.68 至 36.38）、Miller（OR = 4.77，95%CI = 1.32 至 17.22）、Glidescope（OR = 2.76，95%CrI = 1.60 至 4.75）和 McGrath（OR = 4.61，95%CI = 1.18 至 17.99）获得了更高的 PFS。同时，Airtraq 在 PFS 方面优于 Glidescope（OR = 0.21，95%CI = 0.07 至 0.65）。对于 TTI，加拿大优于其他插管设备，CMAC 优于 TruViewEVO2、Glidescope 和 StorzDCI。与 Macintosh 和 Pentax 相比，Airtraq 降低了 LC 的风险，但 Airtraq 与 KingVision 之间没有统计学差异。在儿科插管中，Airtraq 可能是 FPS 的最佳选择，加拿大是 TTI 的最佳选择，KingVision 是 LC 的最佳选择。
