Ultrasound identification of the cricothyroid membrane. Systematic review and meta-analysis.
Introduction: The no-ventilation no-oxygenation situation is extremely important due to its high mortality. In these cases, open cricothyroidotomy is indicated. Around fifty percent of the difficulties are the result of inadequate identification of the cricothyroid membrane (CTM). Objective: To dete...
| Publicado en: | Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología Vol. 51; no. 3; pp. 1 - 25 |
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| Autores principales: | , , |
| Formato: | Artículo |
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Sociedad Colombiana de Anestesiologia y Reanimacion
Jul-Sep2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=172264361&site=ehost-live header: @attributes: shortDbName: lth uiTerm: 172264361 longDbName: MedicLatina uiTag: AN controlInfo: bkinfo: jinfo: jid: 01203347 B54X jtl: Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología issn: 01203347 maglogo: N pubinfo: dt: Jul-Sep2023 vid: 51 iid: 3 pid: 56584 pub: Sociedad Colombiana de Anestesiologia y Reanimacion artinfo: ui: 172264361 10.5554/22562087.e1071 ppf: 1 ppct: 24 formats: fmt: @attributes: type: P size: 3MB tig: atl: Ultrasound identification of the cricothyroid membrane. Systematic review and meta-analysis. aug: au: Zamudio Burbano, Mario Castro Berrío, Felipe Prada Escobar, David affil: Hospital Alma Mater de Antioquia. Medellín, Colombia School of Medicine, Universidad de Antioquia. Medellín, Colombia su: Ultrasonic imaging Clinical trials Palpation Cricothyrotomy Sensitivity analysis sug: subj: Ultrasonic imaging Clinical trials Palpation Cricothyrotomy Sensitivity analysis keyword: Airway management Anesthesiology Cricoid membrane Meta-analysis Systematic review Ultrasound Anestesiología Manejo de vía aérea Membrana cricotiroidea Metaanálisis Revisión sistemática Ultrasonido ab: Introduction: The no-ventilation no-oxygenation situation is extremely important due to its high mortality. In these cases, open cricothyroidotomy is indicated. Around fifty percent of the difficulties are the result of inadequate identification of the cricothyroid membrane (CTM). Objective: To determine whether ultrasonography is superior to palpation to identify the CTM at the first attempt. Methods: A systematic review and a meta-analysis were conducted on the identification of the cricothyroid membrane versus palpation in Medline/Central and Embase. Clinical controlled trials and observational studies were included. Two authors independently and in duplicate selected the studies, assessed the biases and extracted the data; a random effects meta-analysis was successfully conducted for the correct identification of the CTM. The risk of bias was assessed and the certainty of the evidence was qualified. CRD42021223961. Results: 464 studies were included of which 15 met the eligibility criteria; 6 were clinical trials y 9 were observational. Ultrasound is superior to palpation in the detection of the CTM (RR 1.88, 95 % CI 1.05-3.36) according to the clinical trials, and it was also superior in observational studies (RR 1.76, 95 % CI 1.36-2.28). The association was preserved in the sensitivity analyses. Conclusions: Ultrasonography is superior to palpation for the correct identification of the TCM, though the certainty of the evidence is low. Further studies with better methodology are needed to improve both certainty and precision. Introducción: La situación de no ventilación-no oxigenación es de gran importancia dada su elevada mortalidad. En dichos casos, la cricotiroidotomía abierta está indicada. Cerca de la mitad de las dificultades son causadas por inadecuada identificación de la membrana cricotiroidea (MCT. Objetivo: Determinar si la ultrasonografía es superior a la palpación para identificar la MCT al primer intento. Métodos: Se realizó una revisión sistemática y metaanálisis de identificación de membrana cricotiroidea versus palpación en Medline/Central y Embase. Se incluyeron ensayos clínicos controlados y estudios observacionales. Dos autores de manera independiente y por duplicado realizaron la selección de estudios, la evaluación de sesgos y la extracción de datos, se efectuó un metaanálisis de efectos aleatorios con el éxito de identifica-ción correcta de la MCT. Se evaluó el riesgo de sesgos y se calificó la certeza de la evidencia. CRD42021223961. Resultados: Se incluyeron 464 estudios de los cuales 15 cumplieron criterios de elegibilidad, 6 fueron ensayos clínicos y 9 observacionales. La eco-grafía es superior a la palpación para detección de la MCT (RR 1,88, IC 95 % 1,05-3,36) según los ensayos clínicos y, similarmente, fue superior para los estudios observacionales (RR 1,76, IC 95 % 1,36-2,28); la asociación se conservó en los análisis de sensibilidad. Conclusiones: La ultrasonografía es superior a la palpación para detectar correctamente la MCT, aunque con baja certeza de la evidencia. Se re-quieren más estudios con mejor calidad metodológica para mejorar la certeza y la precisión. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: Y custom: Copyright of Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología is the property of Sociedad Colombiana de Anestesiologia y Reanimacion and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. item: Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología holder: Sociedad Colombiana de Anestesiologia y Reanimacion dt: @attributes: year: 2023 holdings: @attributes: islocal: N |
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