Transtracheal jet ventilation in the 'can't intubate can't oxygenate' emergency: a systematic review
Transtracheal jet ventilation in the 'can't intubate can't oxygenate' emergency: a systematic review
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DOI：
10.1093/bja/aew192
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发表时间：
2016-09-01
影响因子：
9.8
通讯作者：
Griesdale, D. E.
中科院分区：
文献类型：
--
作者：
Dugganh, L. V.;Scott, B. Ballantyne;Griesdale, D. E.
背景资料：经气管喷射通气（TTJV）在几个气道指南中被推荐为在“无法插管无法氧合”（CICO）紧急情况下可能挽救生命的程序。一些研究质疑其effectiveness.Methods：我们的目标是确定TTJV的并发症发生率在CICO的紧急情况下，CICO是不描述（非CICO紧急）或择期手术设置相比。系统检索了几个已发表和未发表文献数据库中描述人类受试者TTJV的研究。并发症分类为器械失效、气压伤（包括皮下气肿）和其他。设备故障被定义为无法放置和/或使用TTJV设备，而不是患者survival.Results：44项研究（428例手术）符合纳入标准。4项研究包括急诊和择期手术。30项研究描述了132例紧急TTJV手术; 90例为CICO紧急情况。18项研究描述了296例择期TTJV手术。CICO急诊组42%发生器械失效，非CICO急诊组0%（P
Background: Transtracheal jet ventilation (TTJV) is recommended in several airway guidelines as a potentially life-saving procedure during the 'Can't Intubate Can't Oxygenate' (CICO) emergency. Some studies have questioned its effectiveness.Methods: Our goal was to determine the complication rates of TTJV in the CICO emergency compared with the emergency setting where CICO is not described (non-CICO emergency) or elective surgical setting. Several databases of published and unpublished literature were searched systematically for studies describing TTJV in human subjects. Complications were categorized as device failure, barotrauma (including subcutaneous emphysema), and miscellaneous. Device failure was defined by the inability to place and/or use the TTJV device, not patient survival.Results: Forty-four studies (428 procedures) met the inclusion criteria. Four studies included both emergency and elective procedures. Thirty studies described 132 emergency TTJV procedures; 90 were CICO emergencies. Eighteen studies described 296 elective TTJV procedures. Device failure occurred in 42% of CICO emergency vs 0% of non-CICO emergency (P