Meta-Analysis of Failure of Prehospital Endotracheal Intubation in Pediatric Patients
Prehospital care is essential for airway preservation in pediatric patients who require early endotracheal intubation to improve oxygenation and prevent aspiration. However, high frequencies of failure of endotracheal intubation have been reported for this age group. We aimed to analyze the frequenc...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2020/7012508 |
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| author | Jhon Jairo Rodríguez Luis Felipe Higuita-Gutiérrez Edwar Arturo Carrillo Garcia Esneider Castaño Betancur Mauricio Luna Londoño Sara Restrepo Vargas |
| author_facet | Jhon Jairo Rodríguez Luis Felipe Higuita-Gutiérrez Edwar Arturo Carrillo Garcia Esneider Castaño Betancur Mauricio Luna Londoño Sara Restrepo Vargas |
| author_sort | Jhon Jairo Rodríguez |
| collection | DOAJ |
| description | Prehospital care is essential for airway preservation in pediatric patients who require early endotracheal intubation to improve oxygenation and prevent aspiration. However, high frequencies of failure of endotracheal intubation have been reported for this age group. We aimed to analyze the frequency of failure of endotracheal intubation in pediatric patients within a prehospital context and compare it with adult patients. Thus, a systematic revision of literature with a meta-analysis was performed using a study search and selection strategy ensuring extensiveness, sensitivity, and reproducibility. Meta-analyses were performed for odds ratio, DerSimonian and Laird’s Q test was used to assess heterogeneity, and Egger and Begg’s test was used to assess publication bias. Overall, 17 papers and 8772 patients were included, and the main cause of prehospital care was assessed to be trauma. Failed endotracheal intubation frequency was 0.4%–52.6% in pediatric patients. The most frequent complication was with esophageal intubation. Forest plot suggests that risk of failure during intubation of pediatric patients is 3.54 fold higher than that observed for adults. It was concluded that airway management in pediatric patients within a prehospital context is a challenge for prehospital care providers because it entails clear physiological and anatomical differences and a low frequency of exposure to this kind of events as opposed to adults. These differences support a widely higher risk of failure of intubation, suggesting the necessity of consistently trained prehospital care providers to ensure proficiency in technique as well as availability of the required equipment. |
| format | Article |
| id | doaj-art-c32d6c22540f4926b3ffe0efd16ada53 |
| institution | OA Journals |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-c32d6c22540f4926b3ffe0efd16ada532025-08-20T02:19:01ZengWileyEmergency Medicine International2090-28402090-28592020-01-01202010.1155/2020/70125087012508Meta-Analysis of Failure of Prehospital Endotracheal Intubation in Pediatric PatientsJhon Jairo Rodríguez0Luis Felipe Higuita-Gutiérrez1Edwar Arturo Carrillo Garcia2Esneider Castaño Betancur3Mauricio Luna Londoño4Sara Restrepo Vargas5Infettare Research Group, School of Medicine, Universidad Cooperativa de Colombia, Clínica Antioquia, IPS Universitaria Universidad de Antioquia, Medellín, ColombiaInfettare Research Group, School of Medicine, Universidad Cooperativa de Colombia, School of Microbiology, Universidad de Antioquia, Medellín, ColombiaInfettare Research Group, Universidad Cooperativa de Colombia, Medellín, ColombiaInfettare Research Group, Universidad Cooperativa de Colombia, Medellín, ColombiaInfettare Research Group, Universidad Cooperativa de Colombia, Medellín, ColombiaInfettare Research Group, Universidad Cooperativa de Colombia, Medellín, ColombiaPrehospital care is essential for airway preservation in pediatric patients who require early endotracheal intubation to improve oxygenation and prevent aspiration. However, high frequencies of failure of endotracheal intubation have been reported for this age group. We aimed to analyze the frequency of failure of endotracheal intubation in pediatric patients within a prehospital context and compare it with adult patients. Thus, a systematic revision of literature with a meta-analysis was performed using a study search and selection strategy ensuring extensiveness, sensitivity, and reproducibility. Meta-analyses were performed for odds ratio, DerSimonian and Laird’s Q test was used to assess heterogeneity, and Egger and Begg’s test was used to assess publication bias. Overall, 17 papers and 8772 patients were included, and the main cause of prehospital care was assessed to be trauma. Failed endotracheal intubation frequency was 0.4%–52.6% in pediatric patients. The most frequent complication was with esophageal intubation. Forest plot suggests that risk of failure during intubation of pediatric patients is 3.54 fold higher than that observed for adults. It was concluded that airway management in pediatric patients within a prehospital context is a challenge for prehospital care providers because it entails clear physiological and anatomical differences and a low frequency of exposure to this kind of events as opposed to adults. These differences support a widely higher risk of failure of intubation, suggesting the necessity of consistently trained prehospital care providers to ensure proficiency in technique as well as availability of the required equipment.http://dx.doi.org/10.1155/2020/7012508 |
| spellingShingle | Jhon Jairo Rodríguez Luis Felipe Higuita-Gutiérrez Edwar Arturo Carrillo Garcia Esneider Castaño Betancur Mauricio Luna Londoño Sara Restrepo Vargas Meta-Analysis of Failure of Prehospital Endotracheal Intubation in Pediatric Patients Emergency Medicine International |
| title | Meta-Analysis of Failure of Prehospital Endotracheal Intubation in Pediatric Patients |
| title_full | Meta-Analysis of Failure of Prehospital Endotracheal Intubation in Pediatric Patients |
| title_fullStr | Meta-Analysis of Failure of Prehospital Endotracheal Intubation in Pediatric Patients |
| title_full_unstemmed | Meta-Analysis of Failure of Prehospital Endotracheal Intubation in Pediatric Patients |
| title_short | Meta-Analysis of Failure of Prehospital Endotracheal Intubation in Pediatric Patients |
| title_sort | meta analysis of failure of prehospital endotracheal intubation in pediatric patients |
| url | http://dx.doi.org/10.1155/2020/7012508 |
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