dc.contributor.author | Fevang, Espen | |
dc.contributor.author | Perkins, Zane | |
dc.contributor.author | Lockey, David | |
dc.contributor.author | Jeppesen, Elisabeth | |
dc.contributor.author | Lossius, Hans Morten | |
dc.date.accessioned | 2018-04-06T08:01:50Z | |
dc.date.available | 2018-04-06T08:01:50Z | |
dc.date.created | 2017-09-13T10:29:10Z | |
dc.date.issued | 2017-07 | |
dc.identifier.citation | Fevang, E. et al. (2017) A systematic review and meta-analysis comparing mortality in pre-hospital tracheal intubation to emergency department intubation in trauma patients. Critical Care, 21:192 | nb_NO |
dc.identifier.issn | 1466-609X | |
dc.identifier.uri | http://hdl.handle.net/11250/2492961 | |
dc.description.abstract | Background
Pre-hospital endotracheal intubation is frequently used for trauma patients in many emergency medical systems. Despite a wide range of publications in the field, it is debated whether the intervention is associated with a favourable outcome, when compared to more conservative airway measures.
Methods
A systematic literature search was conducted to identify interventional and observational studies where the mortality rates of adult trauma patients undergoing pre-hospital endotracheal intubation were compared to those undergoing emergency department intubation.
Results
Twenty-one studies examining 35,838 patients were included. The median mortality rate in patients undergoing pre-hospital intubation was 48% (range 8–94%), compared to 29% (range 6–67%) in patients undergoing intubation in the emergency department. Odds ratios were in favour of emergency department intubation both in crude and adjusted mortality, with 2.56 (95% CI: 2.06, 3.18) and 2.59 (95% CI: 1.97, 3.39), respectively. The overall quality of evidence is very low. Twelve of the twenty-one studies found a significantly higher mortality rate after pre-hospital intubation, seven found no significant differences, one found a positive effect, and for one study an analysis of the mortality rate was beyond the scope of the article.
Conclusions
The rationale for wide and unspecific indications for pre-hospital intubation seems to lack support in the literature, despite several publications involving a relatively large number of patients. Pre-hospital intubation is a complex intervention where guidelines and research findings should be approached cautiously. The association between pre-hospital intubation and a higher mortality rate does not necessarily contradict the importance of the intervention, but it does call for a thorough investigation by clinicians and researchers into possible causes for this finding. | nb_NO |
dc.language.iso | eng | nb_NO |
dc.publisher | BioMed Central | nb_NO |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.subject | akuttmedisin | nb_NO |
dc.subject | endotrakeal intubasjon | nb_NO |
dc.subject | endotrakeal intubering | nb_NO |
dc.subject | emergency medical services | nb_NO |
dc.title | A systematic review and meta-analysis comparing mortality in pre-hospital tracheal intubation to emergency department intubation in trauma patients | nb_NO |
dc.type | Journal article | nb_NO |
dc.type | Peer reviewed | nb_NO |
dc.description.version | publishedVersion | nb_NO |
dc.rights.holder | © The Author(s). 2017 | nb_NO |
dc.subject.nsi | VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Traumatologi: 783 | nb_NO |
dc.source.volume | 21 | nb_NO |
dc.source.journal | Critical Care | nb_NO |
dc.source.issue | 1 | nb_NO |
dc.identifier.doi | 10.1186/s13054-017-1787-x | |
dc.identifier.cristin | 1493213 | |
cristin.unitcode | 217,13,0,0 | |
cristin.unitname | Det helsevitenskapelige fakultet | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 2 | |