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Ultrasound identification of the cricothyroid membrane. Systematic review and meta-analysis.

Authors :
Zamudio Burbano, Mario
Castro Berrío, Felipe
Prada Escobar, David
Source :
Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología. Jul-Sep2023, Vol. 51 Issue 3, p1-24. 24p.
Publication Year :
2023

Abstract

Introduction: The no-ventilation no-oxygenation situation is extremely important due to its high mortality. In these cases, open cricothyroidotomy is indicated. Around fifty percent of the difficulties are the result of inadequate identification of the cricothyroid membrane (CTM). Objective: To determine whether ultrasonography is superior to palpation to identify the CTM at the first attempt. Methods: A systematic review and a meta-analysis were conducted on the identification of the cricothyroid membrane versus palpation in Medline/Central and Embase. Clinical controlled trials and observational studies were included. Two authors independently and in duplicate selected the studies, assessed the biases and extracted the data; a random effects meta-analysis was successfully conducted for the correct identification of the CTM. The risk of bias was assessed and the certainty of the evidence was qualified. CRD42021223961. Results: 464 studies were included of which 15 met the eligibility criteria; 6 were clinical trials y 9 were observational. Ultrasound is superior to palpation in the detection of the CTM (RR 1.88, 95 % CI 1.05-3.36) according to the clinical trials, and it was also superior in observational studies (RR 1.76, 95 % CI 1.36-2.28). The association was preserved in the sensitivity analyses. Conclusions: Ultrasonography is superior to palpation for the correct identification of the TCM, though the certainty of the evidence is low. Further studies with better methodology are needed to improve both certainty and precision. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01203347
Volume :
51
Issue :
3
Database :
Academic Search Index
Journal :
Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología
Publication Type :
Academic Journal
Accession number :
172264361
Full Text :
https://doi.org/10.5554/22562087.e1071