SUPINE VS NON-SUPINE INTUBATION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

TOPIC: Critical Care TYPE: Original Investigations PURPOSE: Endotracheal intubation is performed to secure the airway for various elective and emergent indications, including surgeries, respiratory failure, altered mental status1. Currently, supine position most common used endotracheal intubation2. Intubations in non-supine can be necessary many situations, patients with back pain/lesions, increased aspiration risk, dislodgement of tube during surgery lateral position, amongst other indications3–5. Experience vital as inadequate management these circumstances catastrophic, leading hypoxia, brain injury, even death6. METHODS: We a comprehensive literature search major databases from inception July 2020. The primary outcomes assessed were success rate vs. 1st attempt. secondary overall adverse events. Pooled estimates calculated using random-effects models 95% confidence interval (C.I.). statistical analysis was done STATA v16.1 software (StataCorp, LLC College Station, TX). RESULTS: Our final included 13 clinical trials 1,916 patients. pooled rates vs positions 99.21% (95% CI 97.92-99.95, I2=0.0% p=0.87), 98.82% 97.47-99.75, p=0.60), respectively. semi-erect p=0.81), p=0.49), attempt 85.35% 65.80-97.83, I2= 94.98%, p=0.00) 88.56% 81.76-94.03, 91.37% p=0.00), respectively compared 91.38% 78.89-98.93, 90.76% 77.31-98.86, I2=85.49% total events 3.73% 0.51-8.91, I2=64.93%, p=0.01) 6.74% 2.03-13.45, I2=77.90%, 0.44% 0.00-4.58, I2=72.96, 0.93% 0.00-7.07, I2=83.59%, position. Low substantial heterogeneity noted our analysis. CONCLUSIONS: systematic review meta-analysis demonstrates no significant difference between successful intubations positions. It also showed slightly higher CLINICAL IMPLICATIONS: safe procedure high low risk DISCLOSURES: No relevant relationships by Yussef Al Ghoul, source=Web Response Tareq Arar, Banreet Dhindsa, Rajany Dy, Rajkamal Hansra, Marwan Mashina, Radwan