Success and complications by team composition for prehospital paediatric intubation: A systematic review and meta-analysis

6Citations
Citations of this article
15Readers
Mendeley users who have this article in their library.

This artice is free to access.

Abstract

Background: Clinical team composition for prehospital paediatric intubation may affect success and complication rates. We performed a systematic review and meta-analysis to determine the success and complication rates by type of clinical team. Methods: We searched MEDLINE, EMBASE, and CINAHL for interventional and observational studies describing prehospital intubation attempts in children with overall success, first-pass success, and complication rates. Eligible studies, data extraction, and assessment of risk of bias were assessed independently by two reviewers. We performed a random-effects meta-analysis of proportions. Results: Forty studies (1989 to 2019) described three types of clinical teams: Non-physician teams with no relaxants (22 studies, n = 7602), non-physician teams with relaxants (12 studies, n = 2185), and physician teams with relaxants (12 studies, n = 1780). Twenty-two (n = 3747) and 18 (n = 7820) studies were at low and moderate risk of bias, respectively. Non-physician teams without relaxants had lower overall intubation success rate (72%, 95% CI 67-76%) than non-physician teams with relaxants (95%, 95% CI 93-98%) and physician teams (99%, 95% CI 97-100%). Physician teams had higher first-pass success rate (91%, 95% CI 86-95%) than non-physicians with (75%, 95% CI 69-81%) and without (55%, 95% CI 48-63%) relaxants. Overall airway complication rate was lower in physician teams (10%, 95% CI 3-22%) than non-physicians with (30%, 95% CI 23-38%) and without (39%, 95% CI 28-51%) relaxants. Conclusion: Physician teams had higher rates of intubation success and lower rates of overall airway complications than other team types. Physician prehospital teams should be utilised wherever practicable for critically ill children requiring prehospital intubation.

Cite

CITATION STYLE

APA

Garner, A. A., Bennett, N., Weatherall, A., & Lee, A. (2020, April 15). Success and complications by team composition for prehospital paediatric intubation: A systematic review and meta-analysis. Critical Care. BioMed Central Ltd. https://doi.org/10.1186/s13054-020-02865-y

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free