Effects of sniffing position for tracheal intubation: a meta-analysis of randomized controlled trials

详细信息    查看全文

• 作者：Yuki Akihisa ; MD^a ; ^{ypegtj25@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Hiroshi Hoshijima ; PhD^b ; ¹ ; ^{hhoshi6@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Koichi Maruyama ; PhD^a ; ^{maru555md@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Yukihide Koyama ; PhD^c ; ² ; ^{yukihidekoyama1008@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Tomio Andoh ; PhD^a ; ^{psdelico06@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The American Journal of Emergency Medicine
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：33
• 期：11
• 页码：1606-1611
• 全文大小：686 K

文摘

The purpose of this meta-analysis was to validate the efficacy of the sniffing position in the performance of intubation with direct laryngoscopy.

Methods

We searched MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and Web of Science. Six randomized controlled trials comprising 2759 adult participants were analyzed. The DerSimonian-Laird method was used to calculate pooled relative risk (RR) and the 95% confidence interval (CI) of Cormack-Lehane classification, Intubation Difficulty Scale, success rate of the first intubation, and weighted mean difference of intubation time.

Results

Compared with the other head positions, the sniffing position did not improve glottic visualization, success rate of the first intubation, or intubation time. However, the sniffing position was significantly associated with better Intubation Difficulty Scale compared with the simple head extension position. (RR,1.28; 95% CI, 1.15-1.42; p < 0.0001)

Conclusions

Although patients do not benefit from the sniffing position in terms of glottic visualization, success rate of the first intubation, or intubation time, the sniffing position can still be recommended as the initial head position for tracheal intubation because the sniffing position provides easier intubation conditions.