| No evidence for decreased incidence of aspiration after rapid sequence induction. | |
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MedLine Citation:
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PMID: 17766743 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The purpose of this structured, evidence-based, clinical update was to determine if rapid sequence induction is a safe or effective technique to decrease the risk of aspiration or other complications of airway management. SOURCE: In June 2006 a structured search of MEDLINE from 1966 to present using OVID software was undertaken with the assistance of a reference librarian. Medical subject headings and text words describing rapid sequence induction or intubation (RSI), crash induction or intubation, cricoid pressure and emergency airway intubation were employed. OVID's therapy (sensitivity) algorithm was used to maximize the detection of randomized trials while excluding non-randomized research. The bibliographies of eligible publications were hand-searched to identify trials not identified in the electronic search. PRINCIPAL FINDINGS: A total of 184 clinical trials were identified of which 163 were randomized controlled trials (RCTs). Of these clinical trials, 126 evaluated different drug regimens with 114 being RCTs. Only 21 clinical trials evaluated non-pharmacologic aspects of the RSI with 18 RCTs identified. A parallel search found 52 trials evaluating cricoid pressure (outside of the context of an RSI technique) with 44 classified as RCTs. Definitive outcomes such as prevention of aspiration and mortality benefit could not be evaluated from the trials. Likewise, the impact on adverse outcomes of the different components of RSI could not be ascertained. CONCLUSION: An absence of evidence from RCTs suggests that the decision to use RSI during management can neither be supported nor discouraged on the basis of quality evidence. |
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Authors:
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David T Neilipovitz; Edward T Crosby |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Canadian journal of anaesthesia = Journal canadien d'anesthésie Volume: 54 ISSN: 0832-610X ISO Abbreviation: Can J Anaesth Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-09-03 Completed Date: 2007-12-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8701709 Medline TA: Can J Anaesth Country: Canada |
Other Details:
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Languages: eng Pagination: 748-64 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, The Ottawa Hospital and the University of Ottawa, Ontario K1Y 4E9, Canada. dneilipovitz@ottawahospital.on.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia, General
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adverse effects*,
methods Cricoid Cartilage Drug Administration Schedule Evidence-Based Medicine Female Humans Intubation, Intratracheal / methods* Male Oxygen Inhalation Therapy / methods Respiratory Aspiration / etiology, prevention & control* Respiratory Mechanics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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