Comparison of Laryngeal Ultrasound and Cuff Leak Test to Predict Post-Extubation Stridor in Total Thyroidectomy

Bhargava, Tanvi; Kumar, Abhishek; Bharti, Aruna; Khuba, Sandeep

doi:10.5152/tjar.2020.176

Cited by 2 publications

(8 citation statements)

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“…The characteristics of the included studies published between 2013 and 2021 are shown in Table 1 . Of the 11 studies, eight provided details for the calculation of sensitivity and specificity ( 9 , 13 , 14 , 18 , 19 , 22 , 23 , 25 ). Eight ( 9 , 14 , 18 – 23 ) and seven studies ( 9 , 14 , 18 , 20 , 21 , 23 , 24 ) were available for analysis of the association of PES with ACWD and the duration of intubation, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The incidence of PES was 4–25%. Six studies were conducted in Egypt ( 9 , 14 , 18 , 20 , 22 , 25 ), two in India ( 19 , 24 ), one each in the USA ( 21 ), Thailand ( 23 ), and Iran ( 13 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 11 studies, eight provided details for the calculation of sensitivity and specificity (9,13,14,18,19,22,23,25). Eight (9,14,(18)(19)(20)(21)(22)(23) and seven studies (9,14,18,20,21,23,24) were available for analysis of the association of PES with ACWD and the duration of intubation, respectively. Most studies (i.e., 10) were conducted prospectively in the intensive care unit setting (9,13,14,18,(20)(21)(22)(23)(24)(25) and one was performed in the operating room setting (19).…”

Section: Selection and Characteristics Of Studiesmentioning

confidence: 99%

“…Eight (9,14,(18)(19)(20)(21)(22)(23) and seven studies (9,14,18,20,21,23,24) were available for analysis of the association of PES with ACWD and the duration of intubation, respectively. Most studies (i.e., 10) were conducted prospectively in the intensive care unit setting (9,13,14,18,(20)(21)(22)(23)(24)(25) and one was performed in the operating room setting (19). All studies were mixed-gender (females: 24.1-68.5%) with sample sizes ranging from 41 to 432.…”

Section: Selection and Characteristics Of Studiesmentioning

confidence: 99%

“…Eight studies including 1,129 participants were available for the analysis of ACWD between patients with and those without PES (9,14,(18)(19)(20)(21)(22)(23). By adopting a random-effects model, patients with PES had a smaller ACWD compared to those without PES (mean difference = −0.54, 95% CI = −0.79 to −0.28, I 2 : 97%) (Figure 7).…”

Section: The Differences In Air Column Width Difference and Duration ...mentioning

confidence: 99%

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Diagnostic efficacy of sonographic measurement of laryngeal air column width difference for predicting the risk of post-extubation stridor: A meta-analysis of observational studies

et al. 2023

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BackgroundThis meta-analysis aimed at assessing the diagnostic accuracy of ultrasound-measured laryngeal air column width difference (ACWD) in predicting post-extubation stridor (PES) in intubated adult patients.MethodsWe searched the Medline, Cochrane Library, EMBASE, and Google scholar databases from inception to October, 2022 to identify studies that examined the diagnostic accuracy of ACWD for PES. The primary outcome was the diagnostic performance by calculating the pooled sensitivity, specificity, and area under the curve (AUC). The secondary outcomes were the differences in ACWD and duration of intubation between patients with and without PES.ResultsFollowing literature search, 11 prospective studies (intensive care setting, n = 10; operating room setting, n = 1) involving 1,322 extubations were included. The incidence of PES among the studies was 4–25%. All studies were mixed-gender (females: 24.1–68.5%) with sample sizes ranging between 41 and 432. The cut-off values of ACWD for prediction of PES varied from 0.45 to 1.6 mm. The pooled sensitivity and specificity of ACWD for PES were 0.8 (95% CI = 0.69–0.88, I2: 37.26%, eight studies) and 0.81 (95% CI = 0.72–0.88, I2: 89.51%, eight studies), respectively. The pooled AUC was 0.87 (95% CI = 0.84–0.90). Patients with PES had a smaller ACWD compared to those without PES (mean difference = −0.54, 95% CI = −0.79 to −0.28, I2: 97%, eight studies). Moreover, patients with PES had a longer duration of tracheal intubation than that in those without (mean difference = 2.75 days, 95% CI = 0.92, 4.57, I2: 90%, seven studies).ConclusionUltrasound-measured laryngeal ACWD showed satisfactory sensitivity and specificity for predicting PES. Because of the limited number of studies available, further investigations are needed to support our findings.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022375772.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Selection and Characteristics Of Studiesmentioning

confidence: 99%

Section: Selection and Characteristics Of Studiesmentioning

confidence: 99%

Section: The Differences In Air Column Width Difference and Duration ...mentioning

confidence: 99%

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Diagnostic efficacy of sonographic measurement of laryngeal air column width difference for predicting the risk of post-extubation stridor: A meta-analysis of observational studies

et al. 2023

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Point-of-Care Ultrasound in Airway Evaluation and Management: A Comprehensive Review

et al. 2023

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Airway management is a common and critical procedure in acute settings, such as the Emergency Department (ED) or Intensive Care Unit (ICU) of hospitals. Many of the traditional physical examination methods have limitations in airway assessment. Point-of-care ultrasound (POCUS) has emerged as a promising tool for airway management due to its familiarity, accessibility, safety, and non-invasive nature. It can assist physicians in identifying relevant anatomy of the upper airway with objective measurements of airway parameters, and it can guide airway interventions with dynamic real-time images. To date, ultrasound has been considered highly accurate for assessment of the difficult airway, confirmation of proper endotracheal intubation, prediction of post-extubation laryngeal edema, and preparation for cricothyrotomy by identifying the cricothyroid membrane. This review aims to provide a comprehensive overview of the key evidence on the use of ultrasound in airway management. Databases including PubMed and Embase were systematically searched. A search strategy using a combination of the term “ultrasound” combined with several search terms, i.e., “probe”, “anatomy”, “difficult airway”, “endotracheal intubation”, “laryngeal edema”, and “cricothyrotomy” was performed. In conclusion, POCUS is a valuable tool with multiple applications ranging from pre- and post-intubation management. Clinicians should consider using POCUS in conjunction with traditional exam techniques to manage the airway more efficiently in the acute setting.

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Comparison of Laryngeal Ultrasound and Cuff Leak Test to Predict Post-Extubation Stridor in Total Thyroidectomy

Cited by 2 publications

References 13 publications

Diagnostic efficacy of sonographic measurement of laryngeal air column width difference for predicting the risk of post-extubation stridor: A meta-analysis of observational studies

Diagnostic efficacy of sonographic measurement of laryngeal air column width difference for predicting the risk of post-extubation stridor: A meta-analysis of observational studies

Point-of-Care Ultrasound in Airway Evaluation and Management: A Comprehensive Review

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