PDF(Pubmed)
Abstract：
UNASSIGNED: Airway management is a core component of the treatment of cardiac arrest. Where a rescuer cannot establish a patent airway to provide oxygenation and ventilation using standard basic and advanced airway techniques, there may be a need to consider emergency front-of-neck airway access (eFONA, e.g., cricothyroidotomy), but there is limited evidence to inform this approach.
UNASSIGNED: This scoping review aims to identify the evidence for the use of eFONA techniques in patients with cardiac arrest.
UNASSIGNED: In November 2023, we searched Medline, Embase, and Cochrane Central to identify studies on eFONA in adults. We included randomised controlled trials, non-randomised studies, and case series with at least five cases that described any use of eFONA. We extracted data, including study setting, population characteristics, intervention characteristics, and outcomes. Our analysis focused on four key areas: incidence of eFONA, eFONA success rates, clinical outcomes, and complications.
UNASSIGNED: The search identified 21,565 papers, of which 18,934 remained after de-duplication. After screening, we included 69 studies (53 reported incidence, 40 reported success rate, 38 reported clinical outcomes; 36 studies reported complications). We identified only one randomised controlled trial. Across studies, there was a total of 4,457 eFONA attempts, with a median of 31 attempts (interquartile range 16-56.5) per study. There was marked heterogeneity across studies that precluded any pooling of data. There were no studies that included only patients in cardiac arrest.
UNASSIGNED: The available evidence for eFONA is extremely heterogeneous, with no studies specifically focusing on its use in adults with cardiac arrest.
UNASSIGNED: This scoping review aims to identify the evidence for the use of eFONA techniques in patients with cardiac arrest.
UNASSIGNED: In November 2023, we searched Medline, Embase, and Cochrane Central to identify studies on eFONA in adults. We included randomised controlled trials, non-randomised studies, and case series with at least five cases that described any use of eFONA. We extracted data, including study setting, population characteristics, intervention characteristics, and outcomes. Our analysis focused on four key areas: incidence of eFONA, eFONA success rates, clinical outcomes, and complications.
UNASSIGNED: The search identified 21,565 papers, of which 18,934 remained after de-duplication. After screening, we included 69 studies (53 reported incidence, 40 reported success rate, 38 reported clinical outcomes; 36 studies reported complications). We identified only one randomised controlled trial. Across studies, there was a total of 4,457 eFONA attempts, with a median of 31 attempts (interquartile range 16-56.5) per study. There was marked heterogeneity across studies that precluded any pooling of data. There were no studies that included only patients in cardiac arrest.
UNASSIGNED: The available evidence for eFONA is extremely heterogeneous, with no studies specifically focusing on its use in adults with cardiac arrest.
摘要：
■气道管理是心脏骤停治疗的核心组成部分。如果救援人员无法使用标准的基本和先进的气道技术建立通畅的气道以提供氧合和通气，可能需要考虑紧急颈前气道接入(eFONA，例如，环甲甲状腺切开术)，但这种方法的证据有限。
■本范围审查旨在确定在心脏骤停患者中使用eFONA技术的证据。
■2023年11月，我们搜索了Medline，Embase,和CochraneCentral确定成人eFONA的研究。我们纳入了随机对照试验，非随机研究，和案例系列，至少有五个案例描述了eFONA的任何使用。我们提取数据,包括学习设置，人口特征，干预特点，和结果。我们的分析集中在四个关键领域：eFONA的发病率，eFONA成功率,临床结果，和并发症。
■搜索确定了21,565篇论文，其中18,934个在去重之后仍然存在。筛选后,我们纳入了69项研究(53例报告的发病率，40报告成功率，38项报告了临床结果；36项研究报告了并发症）。我们仅确定了一项随机对照试验。在整个研究中，总共有4457次eFONA尝试，每个研究的中位数为31次尝试（四分位距16-56.5）。研究中存在明显的异质性，排除了任何数据汇集。没有仅包括心脏骤停患者的研究。
■关于eFONA的现有证据极其异构，没有专门针对其在患有心脏骤停的成年人中使用的研究。
■本范围审查旨在确定在心脏骤停患者中使用eFONA技术的证据。
■2023年11月，我们搜索了Medline，Embase,和CochraneCentral确定成人eFONA的研究。我们纳入了随机对照试验，非随机研究，和案例系列，至少有五个案例描述了eFONA的任何使用。我们提取数据,包括学习设置，人口特征，干预特点，和结果。我们的分析集中在四个关键领域：eFONA的发病率，eFONA成功率,临床结果，和并发症。
■搜索确定了21,565篇论文，其中18,934个在去重之后仍然存在。筛选后,我们纳入了69项研究(53例报告的发病率，40报告成功率，38项报告了临床结果；36项研究报告了并发症）。我们仅确定了一项随机对照试验。在整个研究中，总共有4457次eFONA尝试，每个研究的中位数为31次尝试（四分位距16-56.5）。研究中存在明显的异质性，排除了任何数据汇集。没有仅包括心脏骤停患者的研究。
■关于eFONA的现有证据极其异构，没有专门针对其在患有心脏骤停的成年人中使用的研究。
