Cuffed versus uncuffed endotracheal tubes in pediatrics: A meta-analysis

Abstract

Background: Cuffed and uncuffed endotra- cheal tubes are commonly used for pediatric patients in surgery and emergency situations. It is still controver- sial which approach should be adopted. The purpose of the study was to compare the application of cuffed and uncuffed endotracheal tubes in pediatric patients. Methods: We searched PubMed, Web of Science and Cochrane Library for clinical trials, which compared the two applications in children. The study characteristics and clinical data were summarized by two independ- ent reviewers. Meta-analysis of the data was done using Revman 5.3 software. Results: 6 studies with 4141 cases were included in this meta-analysis. The pooling analysis showed that more patients need tube changes in uncuffed than cuffed tubes (OR: 0.07, 95% CI: 0.05-0.10, P < 0.00001). However, there were no differences on intubation duration, reintubation occurrence, accidental extubation rate, croup occur- rence and racemic epinephrine use during the intubation process. Also we didn't find any differences on laryngo- spasm and stridor occurrence after extubation. Conclusions: Our study demonstrated that uncuffed endotracheal tubes increased the need for tube changes. Other incidences or complications between the two groups had no differences. Cuffed tubes may be an optimal option for pediatric patients. But more trials are needed in the future.