scholarly journals Metaanálisis entre la videolaringoscopia y la laringoscopia directa en el manejo de la vía aérea difícil por parte de anestesiólogos experimentados

2018 ◽  
Vol 10 (8) ◽  
pp. 5
Author(s):  
Orreaga Zugasti Echarte
Keyword(s):  
Systematic Review ◽  
Tracheal Intubation ◽  
Difficult Airway ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Added Value ◽  
Initial Management ◽  
Revisión Sistemática ◽  
Para Determinar ◽  
First Time

En este artículo se presenta una revisión sistemática y metaanálisis para determinar si la literatura indicaba que los videolaringoscopios suponen una ventaja sobre la laringoscopia directa cuando son utilizados por anestesiólogos experimentados en el manejo de la vía aérea difícil prevista. El éxito en la intubación al primer intento fue mayor en el grupo de los videolaringoscopios. Su uso también se asoció con una significativa mejor visión de la glotis y con un menor traumatismo de la mucosa de la vía aérea. Se concluye que la videolaringoscopia es un valor añadido para el anestesiólogo experimentado, mejorando la intubación en el primer intento, la visión de la glotis y reduciendo el trauma de la mucosa, pudiendo tener un papel importante en el abordaje inicial de la vía aérea difícil prevista. ABSTRACT This article presents a systematic review and meta-analysis to ascertain if the literature indicated if videolaryngoscopy conferred an advantage when used by experienced anaesthetists managing patients with a known difficult airway. First-attempt success of tracheal intubation was higher in the videolaryngoscopy group. Use of videolaryngoscopy was also associated with a significantly better view of the glottis and with a less rate of airway mucosal trauma. Videolaryngoscopy has added value for the experienced anaesthetist, improving first-time success, the view of the glottis and reducing mucosal trauma. It could become a standard of care in the initial management of the known difficult airway.

scholarly journals Useful Ultrasonographic Parameters to Predict Difficult Laryngoscopy and Difficult Tracheal Intubation—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Sara H. Gomes ◽  
Ana M. Simões ◽  
Andreia M. Nunes ◽  
Marta V. Pereira ◽  
Wendy H. Teoh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Tracheal Intubation ◽  
Difficult Airway ◽  
Anterior Commissure ◽  
Meta Analysis ◽  
Small Sample ◽  
Difficult Laryngoscopy ◽  
Routine Practice ◽  
Neutral Position ◽  
Vocal Cords

Unexpected difficult airway management can cause significant morbidity and mortality in patients admitted for elective procedures. Ultrasonography is a promising tool for perioperative airway assessment, nevertheless it is still unclear which sonographic parameters are useful predictors of difficult laryngoscopy and tracheal intubation. To determine the ultrasonographic predictors of a difficult airway that could be applied for routine practice, a systematic review and meta-analysis was conducted. Literature search was performed on PubMED, Web of Science and Embase using the selected keywords. Human primary studies, published in English with the use of ultrasonography to prediction of difficult laryngoscopy or tracheal intubation were included. A total of 19 articles (4,570 patients) were analyzed for the systematic review and 12 articles (1,141 patients) for the meta-analysis. Standardized mean differences between easy and difficult laryngoscopy groups were calculated and the parameter effect size quantified. A PRISMA methodology was used and the critical appraisal tool from Joanna Briggs Institute was applied. Twenty-six sonographic parameters were studied. The overall effect of the distance from skin to hyoid bone (p = 0.02); skin to epiglottis (p = 0.02); skin to the anterior commissure of vocal cords (p = 0.02), pre-epiglottis space to distance between epiglottis and midpoint between vocal cords (p = 0.01), hyomental distance in neutral (p < 0.0001), and extended (p = 0.0002) positions and ratio of hyomental distance in neutral to extended (p = 0.001) was significant. This study shows that hyomental distance in the neutral position is the most reliable parameter for pre-operative airway ultrasound assessment. The main limitations of the study are the small sample size, heterogeneity of studies, and absence of a standardized ultrasonographic evaluation method [Registered at International prospective register of systematic reviews (PROSPERO): number 167931].

Quality of life in adolescents and young adults with CHD is not reduced: a systematic review and meta-analysis

2015 ◽  
Vol 26 (3) ◽  
pp. 415-425 ◽  
Author(s):  
Morten Schrøder ◽  
Kirsten A. Boisen ◽  
Jesper Reimers ◽  
Grete Teilmann ◽  
Jesper Brok
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Young Adults ◽  
Meta Analysis ◽  
Adolescents And Young Adults ◽  
Analysis Model ◽  
Significant Difference ◽  
Newcastle Ottawa Scale ◽  
First Time

AbstractPurposeWe performed a systematic review and meta-analysis of observational studies assessing quality of life in adolescents and young adults born with CHD compared with age-matched controls.MethodsWe carried out a systematic search of the literature published in Medline, Embase, PsychINFO, and the Cochrane Library’s Database (1990–2013); two authors independently extracted data from the included studies. We used the Newcastle–Ottawa scale for quality assessment of studies. A random effects meta-analysis model was used. Heterogeneity was assessed using the I2-test.ResultsWe included 18 studies with 1786 patients. The studies were of acceptable-to-good quality. The meta-analysis of six studies on quality of life showed no significant difference – mean difference: −1.31; 95% confidence intervals: −6.51 to +3.89, I2=90.9% – between adolescents and young adults with CHD and controls. Similar results were found in 10 studies not eligible for the meta-analysis. In subdomains, it seems that patients had reduced physical quality of life; however, social functioning was comparable or better compared with controls.ConclusionFor the first time in a meta-analysis, we have shown that quality of life in adolescents and young adults with CHD is not reduced when compared with age-matched controls.

scholarly journals ¿Por qué comunicarse en formación a distancia? / Why communicate in Distance Education?

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Cathia Papi ◽  
Gustavo Angulo Mendoza ◽  
Caroline Brassard ◽  
Jean-Luc Bédard ◽  
Christine Sarpentier
Keyword(s):  
Systematic Review ◽  
Distance Education ◽  
Lifelong Learning ◽  
Meta Analysis ◽  
Dropout Rates ◽  
Communication Tools ◽  
Revisión Sistemática

ABSTRACTDistance Education (DE) seems a way to meet the qualification requirements of contemporary societies, promoting lifelong learning anywhere. However, this mode of education often suffers from high dropout rates, notably caused by students’ isolation. The development of various communication tools offers spaces to interact and work together. To what extent do students take advantage of the proposed interaction devices to communicate and learn with others? Based on a systematic review of studies published over the last ten years addressing these types of devices established in Canada, our meta-analysis highlights that in general, students prefer to take advantage of the flexibility of DE and work alone. Thus, in most devices, there are not many students communicating. However, we will see that, when it is not only about socializing but also reflecting on a practice, interactions are much more frequent.RESUMENLa formación a distancia (FAD) parece una manera de responder a las exigencias de cualificación de las socie-dades modernas favoreciendo el aprendizaje en todo momento de la vida y en cualquier lugar. Sin embargo, este modo de formación sufre a menudo de importantes tasas de abandono causadas en parte por el aislamiento de los estudiantes. El desarrollo de diferentes herramientas de comunicación permite ofrecer a los estudiantes a distancia espacios para interactuar y trabajar juntos. ¿En qué medida los estudiantes aprovechan los dispositi-vos de interacción propuestos para comunicarse y aprender con los demás? Basado en una revisión sistemática de los estudios publicados durante los diez últimos años sobre estos tipos de dispositivos establecidos en Cana-dá, nuestro meta-análisis pone en relieve que, de manera general, los estudiantes prefieren aprovechar la flexi-bilidad de la FAD y trabajar solos. Así, en la mayoría de los dispositivos no son muchos los que comunican. Sin embargo, veremos que, cuando no se trata solamente de socializar sino también de reflexionar sobre una prácti-ca, las interacciones se multiplican. Podremos así cuestionar esos resultados a la luz de la teoría de investiga-ción.

scholarly journals Self-sampling for human papillomavirus (HPV) testing: a systematic review and meta-analysis

2019 ◽  
Vol 4 (3) ◽  
pp. e001351 ◽  
Author(s):  
Ping Teresa Yeh ◽  
Caitlin E Kennedy ◽  
Hugo de Vuyst ◽  
Manjulaa Narasimhan
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Clinical Assessment ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Hpv Testing ◽  
Screening Uptake ◽  
Screening Frequency

IntroductionHuman papillomavirus (HPV) self-sampling test kits may increase screening for and early detection of cervical cancer and reduce its burden globally. To inform WHO self-care guidelines, we conducted a systematic review and meta-analysis of HPV self-sampling among adult women on cervical (pre-)cancer screening uptake, screening frequency, social harms/adverse events and linkage to clinical assessment/treatment.MethodsThe included studies compared women using cervical cancer screening services with HPV self-sampling with women using standard of care, measured at least one outcome, and were published in a peer-reviewed journal. We searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CNIAHL), Latin American and Caribbean Health Sciences Literature (LILACS) and Embase through October 2018. Risk of bias was assessed using the Cochrane tool for randomised controlled trials (RCTs) and the Evidence Project tool for non-randomised studies. Meta-analysis was conducted using random-effects models to generate pooled estimates of relative risk (RR).Results33 studies in 34 articles with 369 017 total participants met the inclusion criteria: 29 RCTs and 4 observational studies. All studies examined HPV self-sampling; comparison groups were standard of care (eg, Pap smear, visual inspection with acetic acid, clinician-collected HPV testing). 93% of participants were from high-income countries. All 33 studies measured cervical cancer screening uptake. Meta-analysis found greater screening uptake among HPV self-sampling participants compared with control (RR: 2.13, 95% CI 1.89 to 2.40). Effect size varied by HPV test kit dissemination method, whether mailed directly to home (RR: 2.27, 95% CI 1.89 to 2.71), offered door-to-door (RR: 2.37, 95% CI 1.12 to 5.03) or requested on demand (RR: 1.28, 95% CI 0.90 to 1.82). Meta-analysis showed no statistically significant difference in linkage to clinical assessment/treatment between arms (RR: 1.12, 95% CI 0.80 to 1.57). No studies measured screening frequency or social harms/adverse events.ConclusionA growing evidence base, mainly from high-income countries and with significant heterogeneity, suggests HPV self-sampling can increase cervical cancer screening uptake compared with standard of care, with a marginal effect on linkage to clinical assessment/treatment.Systematic review registration numberPROSPERO CRD42018114871.

scholarly journals Medications to reduce emergence coughing after general anaesthesia with tracheal intubation: a systematic review and network meta-analysis

2020 ◽  
Vol 124 (4) ◽  
pp. 480-495 ◽  
Author(s):  
Alan Tung ◽  
Nicholas A. Fergusson ◽  
Nicole Ng ◽  
Vivien Hu ◽  
Colin Dormuth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Tracheal Intubation ◽  
General Anaesthesia ◽  
Meta Analysis
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