McNarry Alistair F, Ward Patrick, Silas Ubong, Saunders Rhodri, Saunders Sita J
Department of Anaesthesia, St John's Hospital, NHS Lothian, Edinburgh, UK.
Coreva Scientific, Königswinter, Germany.
Patient Saf Surg. 2024 May 28;18(1):20. doi: 10.1186/s13037-024-00402-2.
The Cochrane systematic review and meta-analysis published in 2022 that compared videolaryngoscopy (VL) with direct laryngoscopy (DL) for facilitating tracheal intubation in adults found that all three types of VL device (Macintosh-style, hyper-angulated and channeled) reduced the risk of failed intubation and increased the likelihood of first-pass success. We report the findings of a subgroup re-analysis of the 2022 Cochrane meta-analysis data focusing on the Macintosh-style VL group. This was undertaken to establish whether sufficient evidence exists to guide airway managers in making purchasing decisions for their local institutions based upon individual device-specific performance. This re-analysis confirmed the superiority of Macintosh-style VL over Macintosh DL in elective surgical patients, with similar efficacy demonstrated between the Macintosh-style VL devices examined. Thus, when selecting which VL device(s) to purchase for their hospital, airway managers decisions are likely to remain focused upon issues such as financial costs, portability, cleaning schedules and previous device experience.
2022年发表的一项Cochrane系统评价和荟萃分析比较了视频喉镜（VL）和直接喉镜（DL）在成人气管插管中的应用，发现所有三种类型的VL设备（麦金托什式、超广角和带通道式）均降低了插管失败的风险，并提高了首次通过成功的可能性。我们报告了对2022年Cochrane荟萃分析数据进行亚组重新分析的结果，重点关注麦金托什式VL组。这样做是为了确定是否有足够的证据指导气道管理人员根据个别设备的具体性能为其当地机构做出采购决策。这项重新分析证实了在择期手术患者中，麦金托什式VL优于麦金托什式DL，在所检查的麦金托什式VL设备之间显示出相似的疗效。因此，当气道管理人员为其医院选择购买哪种VL设备时，决策可能仍会集中在财务成本、便携性、清洁计划和以前的设备使用经验等问题上。
