Respiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analysis

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Abstract

To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation.METHODS:We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control.RESULTS:Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients). Three of these studies investigated high-flow nasal cannula (HFNC) for ApOx while standard nasal cannula was used in one. Globally, ApOx was associated with higher minimum SpO2 value compared to those receiving ETI without ApOx (mean difference 2.31%, 95% CI 0.42 to 4.20, p=0.02, I2=0%) but there were not significant differences between groups in severe hypoxemia and intubation related - complications. Concerning other techniques, noninvasive ventilation (NIV) was compared to bag-valve mask in only one RCT and it reduced the degree of desaturation.CONCLUSIONS:ApOx was significantly associated with higher minimum SpO2 registered during the intubation procedure. Further studies are needed to increase the number of included patients and demonstrate the benefit of ApOx and of other respiratory support methods (e.g. NIV, HFNC).
Lingua originaleEnglish
pagine (da-a)98-106
Numero di pagine9
RivistaJournal of Critical Care
Volume41
Stato di pubblicazionePublished - 2017

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Intratracheal Intubation
Critical Illness
Meta-Analysis
Intubation
Noninvasive Ventilation
Masks
PubMed
Libraries
Databases
Cannula

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cita questo

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title = "Respiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analysis",
abstract = "To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation.METHODS:We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control.RESULTS:Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients). Three of these studies investigated high-flow nasal cannula (HFNC) for ApOx while standard nasal cannula was used in one. Globally, ApOx was associated with higher minimum SpO2 value compared to those receiving ETI without ApOx (mean difference 2.31{\%}, 95{\%} CI 0.42 to 4.20, p=0.02, I2=0{\%}) but there were not significant differences between groups in severe hypoxemia and intubation related - complications. Concerning other techniques, noninvasive ventilation (NIV) was compared to bag-valve mask in only one RCT and it reduced the degree of desaturation.CONCLUSIONS:ApOx was significantly associated with higher minimum SpO2 registered during the intubation procedure. Further studies are needed to increase the number of included patients and demonstrate the benefit of ApOx and of other respiratory support methods (e.g. NIV, HFNC).",
keywords = "Airway management, Apneic oxygenation, Endotracheal intubation, Noninvasive ventilation, Oxygen inhalation therapy, Preoxygenation",
author = "Andrea Cortegiani and Antonino Giarratano and Cesare Gregoretti and Raineri, {Santi Maurizio} and Vincenzo Russotto",
year = "2017",
language = "English",
volume = "41",
pages = "98--106",
journal = "Journal of Critical Care",
issn = "0883-9441",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Respiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analysis

AU - Cortegiani, Andrea

AU - Giarratano, Antonino

AU - Gregoretti, Cesare

AU - Raineri, Santi Maurizio

AU - Russotto, Vincenzo

PY - 2017

Y1 - 2017

N2 - To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation.METHODS:We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control.RESULTS:Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients). Three of these studies investigated high-flow nasal cannula (HFNC) for ApOx while standard nasal cannula was used in one. Globally, ApOx was associated with higher minimum SpO2 value compared to those receiving ETI without ApOx (mean difference 2.31%, 95% CI 0.42 to 4.20, p=0.02, I2=0%) but there were not significant differences between groups in severe hypoxemia and intubation related - complications. Concerning other techniques, noninvasive ventilation (NIV) was compared to bag-valve mask in only one RCT and it reduced the degree of desaturation.CONCLUSIONS:ApOx was significantly associated with higher minimum SpO2 registered during the intubation procedure. Further studies are needed to increase the number of included patients and demonstrate the benefit of ApOx and of other respiratory support methods (e.g. NIV, HFNC).

AB - To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation.METHODS:We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control.RESULTS:Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients). Three of these studies investigated high-flow nasal cannula (HFNC) for ApOx while standard nasal cannula was used in one. Globally, ApOx was associated with higher minimum SpO2 value compared to those receiving ETI without ApOx (mean difference 2.31%, 95% CI 0.42 to 4.20, p=0.02, I2=0%) but there were not significant differences between groups in severe hypoxemia and intubation related - complications. Concerning other techniques, noninvasive ventilation (NIV) was compared to bag-valve mask in only one RCT and it reduced the degree of desaturation.CONCLUSIONS:ApOx was significantly associated with higher minimum SpO2 registered during the intubation procedure. Further studies are needed to increase the number of included patients and demonstrate the benefit of ApOx and of other respiratory support methods (e.g. NIV, HFNC).

KW - Airway management

KW - Apneic oxygenation

KW - Endotracheal intubation

KW - Noninvasive ventilation

KW - Oxygen inhalation therapy

KW - Preoxygenation

UR - http://hdl.handle.net/10447/235173

M3 - Article

VL - 41

SP - 98

EP - 106

JO - Journal of Critical Care

JF - Journal of Critical Care

SN - 0883-9441

ER -