Abstract
BackgroundCuffed and uncuffed endotracheal tubes are commonly used for pediatric patients in surgery and emergency situations. It is still controversial which approach should be adopted. The purpose of the study was to compare the application of cuffed and uncuffed endotracheal tubes in pediatric patients.MethodsWe searched PubMed, Web of Science and Cochrane Library for clinical trials, which compared the two applications in children. The study characteristics and clinical data were summarized by two independent reviewers. Meta-analysis of the data was done using Revman 5.3 software.Results6 studies with 4141 cases were included in this meta-analysis. The pooling analysis showed that more patients need tube changes in uncuffed than cuffed tubes (OR: 0.07, 95% CI: 0.05-0.10, P < 0.00001). However, there were no differences on intubation duration, reintubation occurrence, accidental extubation rate, croup occurrence and racemic epinephrine use during the intubation process. Also we didn’t find any differences on laryngospasm and stridor occurrence after extubation.ConclusionsOur study demonstrated that uncuffed endotracheal tubes increased the need for tube changes. Other incidences or complications between the two groups had no differences. Cuffed tubes may be an optimal option for pediatric patients. But more trials are needed in the future.
Highlights
Endotracheal tubes are widely used in pediatric patients in emergency department and surgical operations [1]
A thorough search was done in PubMed, Cochrane Library and Web of Science for the potential studies which compared cuffed and uncuffed endotracheal tubes in children, from the inception to November, 2017, without restriction of languages and article types
We found that more patients in uncuffed group need tube changes than cuffed group (OR: 0.05, 95% confidence intervals (CIs): 0.030.07; P < 0.00001) (Figure 2)
Summary
Endotracheal tubes are widely used in pediatric patients in emergency department and surgical operations [1]. New studies are being done in recent years. This encourages a new pooling of the current evidences. A new meta-analysis is done in the study to demonstrate this issue. Cuffed and uncuffed endotracheal tubes are commonly used for pediatric patients in surgery and emergency situations. It is still controversial which approach should be adopted. The purpose of the study was to compare the application of cuffed and uncuffed endotracheal tubes in pediatric patients
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