Comparison of outcomes between video laryngoscopy and flexible fiberoptic bronchoscopy for endotracheal intubation in adults with cervical neck immobilization: A systematic review and meta-analysis of randomized controlled trials

by Nana Guo, Xuxin Wen, Xiao Wang, Junling Yang, Haidong Zhou, Jianli Guo, Yun Su, Tingxin Zhang

Purpose

Comparing the outcomes of video-laryngoscopy and flexible fiberoptic bronchoscopy for endotracheal intubation in patients with cervical spine immobilization

Methods

All of the comparative studies published in the PubMed, Cochrane Library, Medline, Web of Science, and EMBASE databases as of 8 Jan 2024 were included. All outcomes were analyzed using Review Manager 5.4. The primary outcomes were the successful first-attempt intubation rate, intubation time, heart rate after intubation, mean arterial pressure after intubation, overall intubation success rate, risk of tissue damage and sore throat.

Results

The meta-analysis included six randomized controlled studies with a total of 694 patients. The outcomes of the meta-analysis revealed that the use of video laryngoscopy was better than flexible fiberoptic bronchoscopy in terms of the successful first-attempt intubation rate (P0.05) between the video laryngoscopy and flexible fiberoptic bronchoscopy groups.

Conclusions

Compared with flexible fiberoptic bronchoscopy, video laryngoscopy has superior tracheal intubation performance in terms of the first-attempt success rate and intubation speed. This finding was observed in patients with cervical spine immobilization who utilized a cervical collar to simulate a difficult airway. Additionally, both types of scopes demonstrated similar complication rates. Current evidence suggests that video laryngoscopy is better suited than flexible fiberoptic bronchoscopy for endotracheal intubation in patients immobilized with a cervical collar.

Trial registration

Systematic review protocol: CRD42024499868.

Effect of barbed versus standard sutures on wound complications in total knee arthroplasty: A meta‐analysis

Abstract

A barbed suture has been demonstrated to be effective in shortening the stitching time and improving the aesthetic appearance of the stitches during the entire knee replacement. However, no meta-analyses have been conducted specifically to evaluate the effect of the barbed thread on wound complications relative to the conventional suture. A comprehensive search of the PubMed database, the Embase database, the Cochrane Library and the Web of Science was performed to obtain search data up to June 2023, and only randomised controlled trials were included in this meta-analysis. We used Review Manager 5.3 for data synthesis and analysis. This meta-analysis included eight studies. It was found that the use of barbed sutures did not improve the incidence of the disease, the infection of the wound, the closure of the abscess and the injury. However, because of the limited sample size of the randomised controlled trials for this meta-analysis, the data should be handled with caution. More high-quality, large-sample studies will be required to confirm the results.