Video vs. traditional laryngoscopy for tracheal intubation at birth or in the neonatal unit: A systematic review and meta-analysis
Pourquoi ce travail est dans la base
Une base qui oublie comment elle a trouvé un travail ne peut pas être vérifiée. Voici les voies qui ont admis celui-ci.
Notice bibliographique
Résumé
• Previous evidence considered video laryngoscopy use by neonatal or anesthetic clinicians in delivery rooms, neonatal units or operating rooms. • Moderate certainty evidence that video laryngoscopy increases intubation success for neonatal staff in the delivery room or neonatal unit. • High certainty evidence that video laryngoscopy increases first attempt intubation success for neonatal staff in delivery room or neonatal unit. • Adverse events with video laryngoscopy were infrequent and clinical benefit or harm compared to traditional laryngoscopy could not be excluded. • Video laryngoscopy may be a valuable tool to assist neonatal intubation, particularly when training inexperienced neonatal clinicians. Videolaryngoscopy may increase neonatal intubation success when used by neonatologists and anesthesiologists. It is not known if this is true for intubations by neonatal clinicians only in neonatal units or on delivery suites. To critically appraise evidence on the success of tracheal intubation with video laryngoscopy compared to traditional laryngoscopy in infants at birth or in a neonatal unit. Systematic review of studies identified by MEDLINE, Embase, Cochrane Library, CINAHL and Clinical Trial Databases searched from inception to August 22, 2024, without language restrictions. Studies that addressed the PICOST question: In infants receiving tracheal intubation at birth or on a neonatal unit (population), does video laryngoscopy (intervention), compared with traditional laryngoscopy (comparator), improve success (outcome)? Studies that included preoperative intubation or studies of video laryngoscopy use specifically for difficult airways were excluded. Risk of bias was assessed using Cochrane Risk of Bias 2 or ROBINS-I, meta-analysis using RevMan v. 5.4.1, and certainty of evidence using GRADEPro. Studied outcomes were successful tracheal intubation, successful intubation at first attempt, in-hospital mortality, adverse events attributed to laryngoscopy and perception of the intubating clinician. Of 1261 records screened, six randomized controlled trials reporting 817 infants receiving 862 tracheal intubations were included. Success of intubation was higher overall with video laryngoscopy [ relative risk 1.43; 95% confidence interval 1.15–1.77; p -value = 0.001; moderate certainty evidence] and at first attempt [relative risk 1.56; 95% confidence interval 1.33–1.84; p -value <0.001; high certainty evidence]. For mortality or adverse outcomes including airway trauma, esophageal intubation, desaturation <80%, bradycardia to either <60 or <100 beats/minute, clinical benefit or harm could not be excluded. Two randomised controlled trials reported intubator perceptions, but results could not be combined. Most of the first attempts in the randomised controlled trials were by inexperienced intubators. Four observational studies (3,289 infants; 3,342 intubations) showed increased success at first attempt with video laryngoscopy [relative risk 1.78; 95% confidence interval 1.16–2.74; p -value <0.001; very low certainty evidence]. For infants in the delivery room or neonatal unit, use of video laryngoscopy improved overall and first attempt intubation success. Prospero Registration: CRD42023467940.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,004 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle