Carbon Dioxide vs. Air Insufflation for Pediatric Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
| Autor: | Xue Liu, Peng Huang, Chunwang Ji |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Insufflation
medicine.medical_specialty Colonoscopy Pediatrics law.invention gastrointestinal pain 03 medical and health sciences 0302 clinical medicine Bloating Randomized controlled trial children law colonoscopy Internal medicine Medicine endoscopy Adverse effect Pediatric gastroenterology medicine.diagnostic_test business.industry lcsh:RJ1-570 lcsh:Pediatrics Gastrointestinal Pain Carbon dioxide 030220 oncology & carcinogenesis Meta-analysis Pediatrics Perinatology and Child Health 030211 gastroenterology & hepatology Systematic Review business |
| Zdroj: | Frontiers in Pediatrics, Vol 9 (2021) Frontiers in Pediatrics |
| ISSN: | 2296-2360 |
| DOI: | 10.3389/fped.2021.610066/full |
| Popis: | Background: Carbon dioxide (CO2) insufflation during gastrointestinal (GI) endoscopic procedures has gained popularity in adults. However, its utility in pediatric patients is not known. The current review aimed to compare the efficacy of CO2 vs. air insufflation for GI endoscopic procedures in pediatric patients.Methods: The electronic databases of PubMed, Embase, Scopus, and CENTRAL were searched from the inception of databases to 15th August 2020.Results: All randomized controlled trials (RCTs) comparing CO2 vs. air insufflation for GI endoscopic procedures in pediatric patients were eligible for inclusion. Five RCTs were identified. Pooled analysis of data from 226 patients in the CO2 group and 224 patients in the air group revealed that patients receiving CO2 insufflation were at a lower odds of experiencing postoperative pain as compared to those undergoing the procedure with air (OR: 0.40; 95% CI: 0.19, 0.87; I2 = 62%; p = 0.02). Descriptive analysis indicated no difference in the two groups for abdominal distention after the procedure. Two trials reported elevated CO2 in the study group but without any pulmonary complications. Bloating was reported by two studies and both reported significantly less bloating in the CO2 group.Conclusion: Our study indicates that the incidence of pain may be reduced with the use of CO2 insufflation in pediatric GI endoscopies without a significant risk of adverse events. However, current evidence is from a limited number of trials and not strong to recommend a routine of CO2 in pediatric gastroenterology practice. Further high-quality RCTs are required to supplement current evidence. |
| Databáze: | OpenAIRE |
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