دورية أكاديمية

Effect of the use of an endotracheal tube and stylet versus an endotracheal tube alone on first-attempt intubation success: a multicentre, randomised clinical trial in 999 patients.

التفاصيل البيبلوغرافية
العنوان: Effect of the use of an endotracheal tube and stylet versus an endotracheal tube alone on first-attempt intubation success: a multicentre, randomised clinical trial in 999 patients.
المؤلفون: Jaber, Samir1,2 (AUTHOR) s-jaber@chu-montpellier.fr, Rollé, Amélie3 (AUTHOR), Godet, Thomas4 (AUTHOR), Terzi, Nicolas5 (AUTHOR), Riu, Béatrice6 (AUTHOR), Asfar, Pierre7 (AUTHOR), Bourenne, Jeremy8 (AUTHOR), Ramin, Séverin9 (AUTHOR), Lemiale, Virginie10 (AUTHOR), Quenot, Jean-Pierre11,12,13 (AUTHOR), Guitton, Christophe14 (AUTHOR), Prudhomme, Eloi15,16 (AUTHOR), Quemeneur, Cyril17 (AUTHOR), Blondonnet, Raiko4 (AUTHOR), Biais, Mathieu18,19 (AUTHOR), Muller, Laurent20 (AUTHOR), Ouattara, Alexandre21,22 (AUTHOR), Ferrandiere, Martine23 (AUTHOR), Saint-Léger, Piehr24 (AUTHOR), Rimmelé, Thomas25 (AUTHOR)
المصدر: Intensive Care Medicine. Jun2021, Vol. 47 Issue 6, p653-664. 12p. 1 Diagram, 2 Charts, 2 Graphs.
مصطلحات موضوعية: *ENDOTRACHEAL tubes, *TRACHEA intubation, *INTUBATION, *INTENSIVE care units, *CLINICAL trials, *RANDOMIZED controlled trials, *RESEARCH, *RESEARCH methodology, *MEDICAL cooperation, *EVALUATION research, *CATASTROPHIC illness, *COMPARATIVE studies
مستخلص: Purpose: The effect of the routine use of a stylet during tracheal intubation on first-attempt intubation success is unclear. We hypothesised that the first-attempt intubation success rate would be higher with tracheal tube + stylet than with tracheal tube alone.Methods: In this multicentre randomised controlled trial, conducted in 32 intensive care units, we randomly assigned patients to tracheal tube + stylet or tracheal tube alone (i.e. without stylet). The primary outcome was the proportion of patients with first-attempt intubation success. The secondary outcome was the proportion of patients with complications related to tracheal intubation. Serious adverse events, i.e., traumatic injuries related to tracheal intubation, were evaluated.Results: A total of 999 patients were included in the modified intention-to-treat analysis: 501 (50%) to tracheal tube + stylet and 498 (50%) to tracheal tube alone. First-attempt intubation success occurred in 392 patients (78.2%) in the tracheal tube + stylet group and in 356 (71.5%) in the tracheal tube alone group (absolute risk difference, 6.7; 95%CI 1.4-12.1; relative risk, 1.10; 95%CI 1.02-1.18; P = 0.01). A total of 194 patients (38.7%) in the tracheal tube + stylet group had complications related to tracheal intubation, as compared with 200 patients (40.2%) in the tracheal tube alone group (absolute risk difference, - 1.5; 95%CI - 7.5 to 4.6; relative risk, 0.96; 95%CI 0.83-1.12; P = 0.64). The incidence of serious adverse events was 4.0% and 3.6%, respectively (absolute risk difference, 0.4; 95%CI, - 2.0 to 2.8; relative risk, 1.10; 95%CI 0.59-2.06. P = 0.76).Conclusions: Among critically ill adults undergoing tracheal intubation, using a stylet improves first-attempt intubation success. [ABSTRACT FROM AUTHOR]
قاعدة البيانات: Academic Search Index
الوصف
تدمد:03424642
DOI:10.1007/s00134-021-06417-y