Tejada-Perdomo Jorman H, Melo-Moreno Carlos E, Tovar-Cardozo Jesús H, Ramos-Castaneda Jorge A
Department of Clinical Sciences, Universidad Surcolombiana, Neiva, Colombia.
Department of Anesthesiology, Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Colombia.
PLoS One. 2024 Dec 11;19(12):e0315301. doi: 10.1371/journal.pone.0315301. eCollection 2024.
The effectiveness of supraglottic airway devices (SGDs) as a strategy for blind endotracheal intubation (ETI) was compared in this study.
A systematic review of clinical trials (CTs) involving SGDs for blind ETI in patients under general anesthesia or simulation manikins, was conducted. CTs that used SGDs for fiberoptic-guided ETI and those conducted in children were excluded. Searches were performed in Embase, MEDLINE (PubMed), Scopus, and LILACS. The primary outcomes examined were the success rate of blind ETI and intubation time. Secondary outcomes were first-attempt intubation success rate and perceived ease of use.
A total of 567 records were identified from databases, and 16 were identified through citation searches. Ultimately, 27 CTs met the inclusion criteria. The Fastrach Intubating Laryngeal Mask Airway (LMA Fastrach), i-gel, Air-Q Intubating Laryngeal Airway, and Supraglottic Airway Laryngopharyngeal Tube (S.A.L.T.) were the most used SGDs for blind ETI. LMA Fastrach was the most frequently compared device in these CTs. Among the studies in patients, LMA Fastrach and i-gel were the devices that showed the shortest intubation time, although it may be influenced by the way intubation time is assessed. The SGDs with the highest overall success rate were i-gel, S.A.L.T., LMA Fastrach, and single-use LMA Fastrach, followed by Air-Q, and the Intubating Laryngeal Tube Suction-Disposable (iLTS-D2), all achieving success rates greater than 90%. AuraGain had the lowest first-attempt and overall success rates for blind ETI with SGDs.
New SGDs have not surpassed the LMA Fastrach effectiveness for blind ETI. The single-use LMA Fastrach combines the efficacy of the reusable LMA Fastrach with the features of other SGDs and may be a suitable replacement for them. The I-gel is also a viable alternative for blind ETI, while the AuraGain may not be recommended for this purpose.
本研究比较了声门上气道装置（SGD）作为盲探气管插管（ETI）策略的有效性。
对涉及全身麻醉患者或模拟人体模型中使用SGD进行盲探ETI的临床试验（CT）进行系统评价。排除使用SGD进行纤维支气管镜引导ETI的CT以及在儿童中进行的CT。在Embase、MEDLINE（PubMed）、Scopus和LILACS中进行检索。检查的主要结局是盲探ETI的成功率和插管时间。次要结局是首次尝试插管成功率和感知易用性。
从数据库中总共识别出567条记录，通过引文检索又识别出16条。最终，27项CT符合纳入标准。Fastrach气管插管喉罩气道（LMA Fastrach）、i-gel、Air-Q气管插管用喉气道和声门上气道咽喉管（S.A.L.T.）是盲探ETI最常用的SGD。LMA Fastrach是这些CT中最常被比较的装置。在患者研究中，LMA Fastrach和i-gel是插管时间最短的装置，尽管这可能受插管时间评估方式的影响。总体成功率最高的SGD是i-gel、S.A.L.T.、LMA Fastrach和一次性LMA Fastrach，其次是Air-Q和一次性气管插管用喉管抽吸（iLTS-D2），所有这些的成功率均超过90%。AuraGain在使用SGD进行盲探ETI时首次尝试和总体成功率最低。
新型SGD在盲探ETI方面尚未超过LMA Fastrach的有效性。一次性LMA Fastrach将可重复使用的LMA Fastrach的功效与其他SGD的特性相结合，可能是它们的合适替代品。I-gel也是盲探ETI的可行替代方案，而AuraGain可能不推荐用于此目的。
