Advanced airway interventions for paediatric cardiac arrest: A systematic review and meta-analysis
| Autor: | Gabrielle Nuthall, Mary-Fran Hazinski, Peter A. Meaney, Steve Schexnayder, Amelia G. Reis, Patrick Van de Voorde, Vinay M. Nadkarni, Robert Bingham, Thomaz Bittencourt-Couto, Kee-Chong Ng, Nazi Torabi, Dianne L. Atkins, Naoki Shimizu, Ian Maconochie, Yong-Kwang Gene Ong, Allan DeCaen, Kevin Nation, Eric J. Lavonas, Glyneva Bradley-Ridout, Laurie J. Morrison, Shinichiro Ohshimo, Janice A. Tijssen, Brooke Baker, Anne-Marie Guergerian |
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| Rok vydání: | 2019 |
| Předmět: |
Comparative Effectiveness Research
medicine.medical_specialty Resuscitation Comparative effectiveness research 030204 cardiovascular system & hematology Emergency Nursing 03 medical and health sciences 0302 clinical medicine Intubation Intratracheal medicine Humans Airway Management Child Intensive care medicine Noninvasive Ventilation business.industry 030208 emergency & critical care medicine Cardiopulmonary Resuscitation Heart Arrest Clinical trial Outcome and Process Assessment Health Care Life support Meta-analysis Propensity score matching Emergency Medicine Observational study Cardiology and Cardiovascular Medicine business Needs Assessment Cohort study |
| Zdroj: | Resuscitation. 138:114-128 |
| ISSN: | 0300-9572 |
| DOI: | 10.1016/j.resuscitation.2019.02.040 |
| Popis: | Aim To assess the use of advanced airway interventions (tracheal intubation (TI) or supraglottic airway (SGA) placement), compared with bag mask ventilation (BMV) alone, for resuscitation of children in cardiac arrest. Methods We searched Medline, EMBASE, and Cochrane Controlled Register of Trials (CENTRAL) for human trials and observational studies published before September 24, 2018 for clinical trials and observational studies with a comparison group. Two investigators reviewed studies for relevance, extracted data, and assessed risk of bias using the GRADE and CLARITY frameworks. Study authors were contacted when necessary to obtain additional data. Critically important outcomes included survival to hospital discharge and survival with good neurological outcome. Results We identified 14 studies, including 1 pseudorandomised clinical trial, 3 observational cohort studies using propensity matching, and 8 simple cohort studies suitable for meta-analysis. The overall certainty of evidence was low to very low. For the critically important outcomes of survival to hospital discharge with good neurologic outcome and survival to hospital discharge results suggested better outcomes achieved with BMV than either TI or SGA; limited data favored SGA over TI. The majority of studies involved out-of-hospital cardiac arrest, with few studies of in-hospital cardiac arrest. Conclusions TI or SGA are not superior to BMV for resuscitation of children in cardiac arrest, but the overall certainty of evidence is low to very low. Well designed randomised efficacy trials are needed to address this important question. |
| Databáze: | OpenAIRE |
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