Fibreoptic Orotracheal Intubation of Obese Patients Using Parker Flex-Tip vs. Standard Endotracheal Tube

Chang, Lee C.; Lee, Susan C.; Ding, Andrew L; Rajagopalan, Suman

doi:10.5152/tjar.2019.28909

Cited by 1 publication

(5 citation statements)

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“…Study characteristics are described in Table 1. Four trials 22–25 included 362 patients receiving nasotracheal intubation with direct laryngoscopy and nine trials 5,9,11,26–31 enrolled 794 patients receiving oral tracheal intubation with various intubating devices. Twelve studies focused on adult patients, whereas one trial 23 examined the intubation outcomes in the paediatric population.…”

Section: Resultsmentioning

confidence: 99%

“…Airway manipulation was performed by anaesthesiologists in most studies. Seven studies 5,9,23,24,27–29 included patients with a low risk of difficult airway, whereas five trials 11,22,25,30,31 did not specify the presence of a difficult airway and one study 26 included patients with obesity.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies with a total of 568 patients (PFT group, n =285 vs. standard polyvinylchloride group, n =283) were available for analysis 5,11,26,28–30 . The criteria for successful first-attempt intubation rate (SFAIR) for both laryngoscopy and nonlaryngoscopy are shown in Supplementary Table 3, http://links.lww.com/EJA/A568.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies with a total of 759 patients (PFT group, n =380 vs. standard polyvinylchloride group, n =379) were available for the analysis 9,11,23,26–30 . The definition of ‘intubation time’ varied among the included studies (Supplemental Table 4, http://links.lww.com/EJA/A568).…”

Section: Resultsmentioning

confidence: 99%

“…The pooled RR of the five studies with a total of 501 patients (PFT group, n¼256 vs. standard polyvinylchloride group, n¼245) that reported the risk of airway trauma 22,23,26,28,30 was 0.83 (95% CI 0.67 to 1.03, P ¼ 0.09; t 2 0, P ¼ 0.83) (median of RR 0.85, range 0.52 to 2.9) (Fig. 8), indicating no difference in risk of airway trauma between PFT and standard polyvinylchloride tubes.…”

Section: Risk Of Airway Traumamentioning

confidence: 99%

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Efficacy and airway complications of Parker Flex-Tip tubes and standard endotracheal tubes during airway manipulation

Hung

Chen

Feng

et al. 2021

European Journal of Anaesthesiology

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BACKGROUND Despite reported superior intubation outcomes associated with Parker Flex-Tip (PFT) tubes compared with those associated with standard polyvinylchloride tubes, the efficacy and safety of PFT tubes remain uncertain. OBJECTIVES To compare the intubation outcomes between PFT and conventional standard polyvinylchloride tubes. DESIGN Meta-analysis of randomised controlled trials. DATA SOURCES Embase, Medline, Google Scholar, PubMed and the Cochrane controlled trials register from inception until 3 January 2021. ELIGIBILITY CRITERIA All randomised trials comparing intubation outcomes between PFT (PFT group) and standard polyvinylchloride (standard polyvinylchloride group) tubes. RESULTS Analysis of the 13 eligible trials showed no significant difference in successful first-attempt intubation rate [risk ratio (RR) 1.20, 95% confidence interval (CI) 0.99 to 1.44] (6 trials, 568 participants), trauma risk (RR 0.83, 95% CI 0.67 to 1.03) (5 trials, 501 participants) as well as the overall risks of epistaxis (RR 0.58, 95% CI 0.26 to 1.31) (3 trials, 262 participants), sore throat (RR 0.90, 95% CI 0.70 to 1.17) (4 trials, 451 participants) and hoarseness (RR 0.71, 95% CI 0.44 to 1.14) (4 trials, 451 participants) between the two groups. However, the intubation time was slightly shorter (weighted mean difference −4.2 s, 95% CI −7.4 to −1.0 s) (8 trials, 759 participants) and the risks of severe epistaxis (RR 0.15, 95% CI 0.03 to 0.84) (3 trials, 262 participants) and overall difficulty in airway manipulation (RR 0.48, 95% CI 0.29 to 0.80) (8 trials, 647 participants) were lower in the PFT group than those in the standard polyvinylchloride group. Trial sequential analysis conclusively confirmed a shorter intubation time with PFT tubes than with standard polyvinylchloride tubes, whereas other intubation outcomes were inconclusive. CONCLUSION The use of PFT tubes for airway manipulation was associated with a shorter intubation time compared with the standard polyvinylchloride tubes. The results of trial sequential analysis suggest the need for further trials and meta-analysis to compare other intubation outcomes associated with the two devices. TRIAL REGISTRATION PROSPERO CRD42020197670.

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Section: Resultsmentioning

confidence: 99%