Comparison of Indirect and Direct Laryngoscopes in Pediatric Patients with a Difficult Airway: A Systematic Review and Meta-Analysis
This meta-analysis was performed to determine whether an indirect laryngoscope is more advantageous than a direct laryngoscope for tracheal intubation in the setting of a difficult pediatric airway. Data on the intubation failure and intubation time during tracheal intubation were extracted from pro...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/11/1/60 |
| _version_ | 1797344353943814144 |
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| author | Risa Takeuchi Hiroshi Hoshijima Takahiro Mihara Shinichi Kokubu Aiji Sato (Boku) Takumi Nagumo Tsutomu Mieda Toshiya Shiga Kentaro Mizuta |
| author_facet | Risa Takeuchi Hiroshi Hoshijima Takahiro Mihara Shinichi Kokubu Aiji Sato (Boku) Takumi Nagumo Tsutomu Mieda Toshiya Shiga Kentaro Mizuta |
| author_sort | Risa Takeuchi |
| collection | DOAJ |
| description | This meta-analysis was performed to determine whether an indirect laryngoscope is more advantageous than a direct laryngoscope for tracheal intubation in the setting of a difficult pediatric airway. Data on the intubation failure and intubation time during tracheal intubation were extracted from prospective and retrospective studies identified through a comprehensive literature search. Data from 10 individual articles (11 trials) were combined, and a DerSimonian and Laird random-effects model was used to calculate either the pooled relative risk (RR) or the weighted mean difference (WMD) and the corresponding 95% confidence interval (CI). Meta-analysis of the 10 articles indicated that the intubation failure of tracheal intubation with an indirect laryngoscope was not significantly different from that of a direct laryngoscope in patients with a difficult airway (RR 0.86, 95% CI 0.51–1.46; <i>p</i> = 0.59; Cochrane’s Q = 50.5; I<sup>2</sup> = 82%). Intubation time with an indirect laryngoscope was also similar to that with a direct laryngoscope (WMD 4.06 s; 95% CI −1.18–9.30; <i>p</i> = 0.13; Cochrane’s Q 39.8; I<sup>2</sup> = 85%). In conclusion, indirect laryngoscopes had the same intubation failure and intubation time as direct laryngoscopes in pediatric patients with a difficult airway. Currently, the benefits of indirect laryngoscopes have not been observed in the setting of a difficult pediatric airway. |
| first_indexed | 2024-03-08T11:02:07Z |
| format | Article |
| id | doaj.art-5e602da063164a829ad4672aebcfcb9e |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-08T11:02:07Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-5e602da063164a829ad4672aebcfcb9e2024-01-26T15:47:36ZengMDPI AGChildren2227-90672023-12-011116010.3390/children11010060Comparison of Indirect and Direct Laryngoscopes in Pediatric Patients with a Difficult Airway: A Systematic Review and Meta-AnalysisRisa Takeuchi0Hiroshi Hoshijima1Takahiro Mihara2Shinichi Kokubu3Aiji Sato (Boku)4Takumi Nagumo5Tsutomu Mieda6Toshiya Shiga7Kentaro Mizuta8Bunkoukai Special Needs Center, 2765-5 Ujiie, Sakura 329-1311, Tochigi, JapanDivision of Dento-Oral Anesthesiology, Graduate School of Dentistry, Tohoku University, 4-1 Seiryomachi, Aoba, Sendai 980-8575, Miyagi, JapanDepartment of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama 236-0004, Kanagawa, JapanDepartment of Anesthesiology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsugagun 321-0293, Tochigi, JapanDepartment of Anesthesiology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 465-8651, Aichi, JapanDepartment of Anesthesiology, Saitama Medical University Hospital, Irumagun 350-0495, Saitama, JapanDepartment of Anesthesiology, Saitama Medical University Hospital, Irumagun 350-0495, Saitama, JapanDepartment of Anesthesiology and Pain Medicine, International University of Health and Welfare Ichikawa Hospital, 6-1-4 Kounodai, Ichikawa 272-0827, Chiba, JapanBunkoukai Special Needs Center, 2765-5 Ujiie, Sakura 329-1311, Tochigi, JapanThis meta-analysis was performed to determine whether an indirect laryngoscope is more advantageous than a direct laryngoscope for tracheal intubation in the setting of a difficult pediatric airway. Data on the intubation failure and intubation time during tracheal intubation were extracted from prospective and retrospective studies identified through a comprehensive literature search. Data from 10 individual articles (11 trials) were combined, and a DerSimonian and Laird random-effects model was used to calculate either the pooled relative risk (RR) or the weighted mean difference (WMD) and the corresponding 95% confidence interval (CI). Meta-analysis of the 10 articles indicated that the intubation failure of tracheal intubation with an indirect laryngoscope was not significantly different from that of a direct laryngoscope in patients with a difficult airway (RR 0.86, 95% CI 0.51–1.46; <i>p</i> = 0.59; Cochrane’s Q = 50.5; I<sup>2</sup> = 82%). Intubation time with an indirect laryngoscope was also similar to that with a direct laryngoscope (WMD 4.06 s; 95% CI −1.18–9.30; <i>p</i> = 0.13; Cochrane’s Q 39.8; I<sup>2</sup> = 85%). In conclusion, indirect laryngoscopes had the same intubation failure and intubation time as direct laryngoscopes in pediatric patients with a difficult airway. Currently, the benefits of indirect laryngoscopes have not been observed in the setting of a difficult pediatric airway.https://www.mdpi.com/2227-9067/11/1/60indirect laryngoscopesdirect laryngoscopespediatricdifficult airwaymeta-analysis |
| spellingShingle | Risa Takeuchi Hiroshi Hoshijima Takahiro Mihara Shinichi Kokubu Aiji Sato (Boku) Takumi Nagumo Tsutomu Mieda Toshiya Shiga Kentaro Mizuta Comparison of Indirect and Direct Laryngoscopes in Pediatric Patients with a Difficult Airway: A Systematic Review and Meta-Analysis Children indirect laryngoscopes direct laryngoscopes pediatric difficult airway meta-analysis |
| title | Comparison of Indirect and Direct Laryngoscopes in Pediatric Patients with a Difficult Airway: A Systematic Review and Meta-Analysis |
| title_full | Comparison of Indirect and Direct Laryngoscopes in Pediatric Patients with a Difficult Airway: A Systematic Review and Meta-Analysis |
| title_fullStr | Comparison of Indirect and Direct Laryngoscopes in Pediatric Patients with a Difficult Airway: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Comparison of Indirect and Direct Laryngoscopes in Pediatric Patients with a Difficult Airway: A Systematic Review and Meta-Analysis |
| title_short | Comparison of Indirect and Direct Laryngoscopes in Pediatric Patients with a Difficult Airway: A Systematic Review and Meta-Analysis |
| title_sort | comparison of indirect and direct laryngoscopes in pediatric patients with a difficult airway a systematic review and meta analysis |
| topic | indirect laryngoscopes direct laryngoscopes pediatric difficult airway meta-analysis |
| url | https://www.mdpi.com/2227-9067/11/1/60 |
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