Efficacy of endotracheal intubation in helicopter cabin vs. ground: a systematic review and meta-analysis.

Autor: Kolaparambil Varghese LJ; University Department of Anaesthesiology, Intensive Care Medicine, and Emergency Medicine, Johannes Wesling Klinikum Minden, University Hospital Ruhr-University Bochum, Minden, Germany. lydia.kolaparambil@gmail.com.; European Society of Aerospace Medicine (ESAM), Cologne, Germany. lydia.kolaparambil@gmail.com., Völlering JJ; Department of Mathematics and Informatics, University of Osnabrück, Osnabrück, Germany., De Robertis E; Division of Anaesthesia, Analgesia, and Intensive Care, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Hinkelbein J; University Department of Anaesthesiology, Intensive Care Medicine, and Emergency Medicine, Johannes Wesling Klinikum Minden, University Hospital Ruhr-University Bochum, Minden, Germany.; European Society of Aerospace Medicine (ESAM), Cologne, Germany., Schmitz J; Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany.; Department of Sleep and Human Factors Research, German Aerospace Centre, Cologne, Germany., Warnecke T; Intensive Care, Emergency Medicine, and Pain Therapy, University Clinic of Anaesthesiology, Klinikum Oldenburg, Oldenburg, Germany.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2024 May 10; Vol. 32 (1), pp. 40. Date of Electronic Publication: 2024 May 10.
DOI: 10.1186/s13049-024-01213-1
Abstrakt: Background: Pre-hospital endotracheal intubation (ETI) is a sophisticated procedure with a comparatively high failure rate. Especially, ETI in confined spaces may result in higher difficulty, longer times, and a higher failure rate. This study analyses if Helicopter Emergency Medical Services (HEMS) intubation (time-to) success are influenced by noise, light, and restricted space in comparison to ground intubation. Available literature reporting these parameters was very limited, thus the reported differences between ETI in helicopter vs. ground by confronting parameters such as time to secure airway, first pass success rate and Cormack-Lehane Score were analysed.
Methods: A systematic review and meta-analysis were conducted using PUBMED, EMBASE, Cochrane Library, and Ovid on October 15th, 2022. The database search provided 2322 studies and 6 studies met inclusion and quality criteria. The research was registered with the International Prospective Register of Systematic Reviews (CRD42022361793).
Results: A total of six studies were selected and analysed as part of the systematic review and meta-analysis. The first pass success rate of ETI was more likely to fail in the helicopter setting as compared to the ground (82,4% vs. 87,3%), but the final success rate was similar between the two settings (96,8% vs. 97,8%). The success rate of intubation in literature was reported higher in physician-staffed HEMS than in paramedic-staffed HEMS. The impact of aircraft type and location inside the vehicle on intubation success rates was inconclusive across studies. The meta-analysis revealed inconsistent results for the mean duration of intubation, with one study reporting shorter intubation times in helicopters (13,0s vs.15,5s), another reporting no significant differences (16,5s vs. 16,8s), and a third reporting longer intubation times in helicopters (16,1s vs. 15,0s).
Conclusion: Further research is needed to assess the impact of environmental factors on the quality of ETI on HEMS. While the success rate of endotracheal intubation in helicopters vs. on the ground is not significantly different, the duration and time to secure the airway, and Cormack-Lehane Score may be influenced by environmental factors. However, the limited number of studies reporting on these factors highlights the need for further research in this area.
(© 2024. The Author(s).)
Databáze: MEDLINE