Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Background/Aims: Carbon dioxide is increasingly used in insufflation during colonoscopy in adult patients; however, air insufflation remains the primary practice among pediatric gastroenterologists. This systematic review and meta-analysis aims to evaluate insufflation using CO2 versus air in colono...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2021-03-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2020-275.pdf |
| _version_ | 1797421129037512704 |
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| author | John Alexander Lata Guacho Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Bruna Furia Buzetti Hourneaux de Moura Megui Marilia Mansilla Gallegos Thomas McCarty Ricardo Katsuya Toma Eduardo Guimarães Hourneaux de Moura |
| author_facet | John Alexander Lata Guacho Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Bruna Furia Buzetti Hourneaux de Moura Megui Marilia Mansilla Gallegos Thomas McCarty Ricardo Katsuya Toma Eduardo Guimarães Hourneaux de Moura |
| author_sort | John Alexander Lata Guacho |
| collection | DOAJ |
| description | Background/Aims: Carbon dioxide is increasingly used in insufflation during colonoscopy in adult patients; however, air insufflation remains the primary practice among pediatric gastroenterologists. This systematic review and meta-analysis aims to evaluate insufflation using CO2 versus air in colonoscopies in pediatric patients. Methods: Individualized search strategies were performed using MEDLINE, Cochrane Library, EMBASE, and LILACS databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane working methodology. Randomized control trials (RCTs) were selected for the present meta-analysis. Pooled proportions were calculated for outcomes including procedure time and abdominal pain immediately and 24 hours post-procedure. Results: The initial search yielded 644 records, of which five RCTs with a total of 358 patients (CO2: n=178 versus air: n=180) were included in the final analysis. The procedure time was not different between the CO2 and air insufflation groups (mean difference, 10.84; 95% confidence interval [CI], -2.55 to 24.22; p=0.11). Abdominal pain immediately post-procedure was significantly lower in the CO2 group (risk difference [RD], -0.15; 95% CI; -0.26 to -0.03; p=0.01) while abdominal pain at 24 hours post-procedure was similar (RD, -0.05; 95% CI; -0.11 to 0.01; p=0.11). Conclusions: Based on this systematic review and meta-analysis of RCT data, CO2 insufflation reduced abdominal pain immediately following the procedure, while pain was similar at 24 hours post-procedure. These results suggest that CO2 is a preferred insufflation technique when performing colonoscopy in pediatric patients. |
| first_indexed | 2024-03-09T07:11:29Z |
| format | Article |
| id | doaj.art-8ab50300ef674ab9afcb3f387874b8c1 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T07:11:29Z |
| publishDate | 2021-03-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-8ab50300ef674ab9afcb3f387874b8c12023-12-03T09:03:08ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432021-03-0154224224910.5946/ce.2020.2757507Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsJohn Alexander Lata Guacho0Diogo Turiani Hourneaux de Moura1Igor Braga Ribeiro2Bruna Furia Buzetti Hourneaux de Moura3Megui Marilia Mansilla Gallegos4Thomas McCarty5Ricardo Katsuya Toma6Eduardo Guimarães Hourneaux de Moura7 Gastrointestinal Endoscopy Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Gastroenterology and Hepatology Pediatric Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Servicio de Gastroenterología, Clínica Maison de Sante del Sur Lima-Perú, Lima, Perú Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Boston, MA, USA Gastroenterology and Hepatology Pediatric Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilBackground/Aims: Carbon dioxide is increasingly used in insufflation during colonoscopy in adult patients; however, air insufflation remains the primary practice among pediatric gastroenterologists. This systematic review and meta-analysis aims to evaluate insufflation using CO2 versus air in colonoscopies in pediatric patients. Methods: Individualized search strategies were performed using MEDLINE, Cochrane Library, EMBASE, and LILACS databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane working methodology. Randomized control trials (RCTs) were selected for the present meta-analysis. Pooled proportions were calculated for outcomes including procedure time and abdominal pain immediately and 24 hours post-procedure. Results: The initial search yielded 644 records, of which five RCTs with a total of 358 patients (CO2: n=178 versus air: n=180) were included in the final analysis. The procedure time was not different between the CO2 and air insufflation groups (mean difference, 10.84; 95% confidence interval [CI], -2.55 to 24.22; p=0.11). Abdominal pain immediately post-procedure was significantly lower in the CO2 group (risk difference [RD], -0.15; 95% CI; -0.26 to -0.03; p=0.01) while abdominal pain at 24 hours post-procedure was similar (RD, -0.05; 95% CI; -0.11 to 0.01; p=0.11). Conclusions: Based on this systematic review and meta-analysis of RCT data, CO2 insufflation reduced abdominal pain immediately following the procedure, while pain was similar at 24 hours post-procedure. These results suggest that CO2 is a preferred insufflation technique when performing colonoscopy in pediatric patients.http://www.e-ce.org/upload/pdf/ce-2020-275.pdfaircarbon dioxidecolonoscopymeta-analysispediatric |
| spellingShingle | John Alexander Lata Guacho Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Bruna Furia Buzetti Hourneaux de Moura Megui Marilia Mansilla Gallegos Thomas McCarty Ricardo Katsuya Toma Eduardo Guimarães Hourneaux de Moura Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Clinical Endoscopy air carbon dioxide colonoscopy meta-analysis pediatric |
| title | Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | insufflation of carbon dioxide versus air during colonoscopy among pediatric patients a systematic review and meta analysis of randomized controlled trials |
| topic | air carbon dioxide colonoscopy meta-analysis pediatric |
| url | http://www.e-ce.org/upload/pdf/ce-2020-275.pdf |
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