Effet de l’application d’une pression cricoïdienne sur l’intubation trachéale chez les patients adultes: revue systématique et méta-analyse

Translated title of the contribution: The effect of cricoid pressure on tracheal intubation in adult patients: a systematic review and meta-analysis

Kuo Chuan Hung, Chao Ting Hung, Yan Yuen Poon, Shao Chun Wu, Kee Hsin Chen, Jen Yin Chen, Ying Jen Chang, I. Wen Chen, Cheuk Kwan Sun, Min Hsien Chiang

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose: This meta-analysis aimed to assess the impact of cricoid pressure (CP) application on intubation outcomes. Source: Electronic databases (i.e., MEDLINE, PubMed, Embase, and Cochrane review) were searched from inception to 2 June 2020 for randomized-controlled trials that assessed the intubation outcomes in adult patients using laryngoscopic approaches with and without the application of CP (i.e., CP vs non-CP group). The primary outcome was the successful first-attempt intubation rate (SFAIR), and the secondary outcomes were intubation time, incidences of poor laryngoscopic views (i.e., Cormack and Lehane grade 3-4), airway complications, and pulmonary aspiration. Principal findings: A total of five trials (published from 2005 to 2018) were included, and all tracheal intubations were performed by anesthesiologists or nurse anesthetists with a video (n = 3) or Macintosh laryngoscope (n = 2) in the operating room. We found no significant difference in SFAIR (risk ratio [RR], 0.98; P = 0.37), incidence of poor laryngoscopic views (RR, 1.49; P = 0.21), and risk of sore throat (RR, 1.17; P = 0.73) between the two groups. Nevertheless, the intubation time on the first successful attempt was slightly longer (weighted mean difference = 4.40 sec, P = 0.002) and risk of hoarseness was higher (RR, 1.70; P = 0.03) in the CP group compared with in the non-CP group. The secondary outcome “pulmonary aspiration” was not analyzed because only one trial was available. Conclusion: The application of CP did not have a negative impact on the SFAIR or laryngoscopic view. Nevertheless, this maneuver may slightly prolong intubation time and increase the risk of postoperative hoarseness.

Translated title of the contributionThe effect of cricoid pressure on tracheal intubation in adult patients: a systematic review and meta-analysis
Original languageFrench
JournalCanadian Journal of Anesthesia
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • cricoid pressure
  • intubation
  • rapid sequence intubation
  • Sellick maneuver

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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