Efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approach
Abstract Introduction Hypoxemia is a common complication of sedation. This meta-analysis aimed to evaluate the efficacy and safety of supraglottic jet oxygenation and ventilation (SJOV) in preventing hypoxemia during sedative procedures. Methods Randomized controlled trials (RCTs) that compared SJOV...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-11-01
|
| Series: | Systematic Reviews |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13643-024-02707-w |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846165460918206464 |
|---|---|
| author | I-Wen Chen Wei-Ting Wang Pei-Chun Lai Chun-Ning Ho Chien-Ming Lin Yao-Tsung Lin Yen-Ta Huang Kuo-Chuan Hung |
| author_facet | I-Wen Chen Wei-Ting Wang Pei-Chun Lai Chun-Ning Ho Chien-Ming Lin Yao-Tsung Lin Yen-Ta Huang Kuo-Chuan Hung |
| author_sort | I-Wen Chen |
| collection | DOAJ |
| description | Abstract Introduction Hypoxemia is a common complication of sedation. This meta-analysis aimed to evaluate the efficacy and safety of supraglottic jet oxygenation and ventilation (SJOV) in preventing hypoxemia during sedative procedures. Methods Randomized controlled trials (RCTs) that compared SJOV with conventional oxygen therapy in sedated patients were searched in five databases (MEDLINE, EMBASE, Cochrane Library, China National Knowledge Infrastructure [CNKI], and Google Scholar) from their inception to March 2024. The primary outcome was the proportion of patients who developed hypoxia (SpO2 < 90%). The secondary outcomes included subclinical respiratory depression (90% ≤ SpO2 < 95%), severe hypoxemia (SpO2 < 75%), airway interventions, adverse events, hemodynamics, propofol dosage, and procedure time. The certainty of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Twelve trials (n = 3058) were included in the analysis. The evidence suggests that SJOV results in a large reduction in the risk of hypoxemia (risk ratio [RR], 0.26; 95% confidence interval, 0.19–0.36; low certainty) and subclinical respiratory depression (RR, 0.40; low certainty) compared with the control. SJOV likely resulted in a large reduction in the risk of severe hypoxemia (RR, 0.22; moderate certainty). In addition, it may result in a large reduction in the need for jaw lift (RR, 0.22; low certainty) and mask ventilation (RR, 0.13; low certainty). The risk of sore throat probably increases with SJOV (RR, 1.71; moderate certainty), whereas SJOV may result in little to no difference in nasal bleeding (RR, 1.75; low certainty). Evidence is very uncertain regarding the effect of SJOV on hemodynamics (very low certainty) and procedure time (very low certainty). SJOV probably resulted in little to no difference in sedative doses between the groups (moderate certainty). Conclusion According to the GRADE approach, SJOV likely results in a large reduction in the risk of severe hypoxemia but probably increases the risk of sore throat. Compared with the control, evidence suggests that SJOV results in a large reduction in the risk of hypoxemia, subclinical respiratory depression, and the need for airway manipulation, with little to no difference in nasal bleeding. The integration of SJOV into clinical practice may help minimize hypoxemic events in at-risk patients. |
| format | Article |
| id | doaj-art-26fb2ee1a2794e96a67a274deff61468 |
| institution | Kabale University |
| issn | 2046-4053 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj-art-26fb2ee1a2794e96a67a274deff614682024-11-17T12:12:30ZengBMCSystematic Reviews2046-40532024-11-0113111510.1186/s13643-024-02707-wEfficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approachI-Wen Chen0Wei-Ting Wang1Pei-Chun Lai2Chun-Ning Ho3Chien-Ming Lin4Yao-Tsung Lin5Yen-Ta Huang6Kuo-Chuan Hung7Department of Anesthesiology, Chi Mei Medical CenterDepartment of Anesthesiology, E-Da HospitalEducation Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Anesthesiology, Chi Mei Medical CenterDepartment of Anesthesiology, Chi Mei Medical CenterDepartment of Anesthesiology, Chi Mei Medical CenterDepartment of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Surgical Intensive Care UnitDepartment of Anesthesiology, Chi Mei Medical CenterAbstract Introduction Hypoxemia is a common complication of sedation. This meta-analysis aimed to evaluate the efficacy and safety of supraglottic jet oxygenation and ventilation (SJOV) in preventing hypoxemia during sedative procedures. Methods Randomized controlled trials (RCTs) that compared SJOV with conventional oxygen therapy in sedated patients were searched in five databases (MEDLINE, EMBASE, Cochrane Library, China National Knowledge Infrastructure [CNKI], and Google Scholar) from their inception to March 2024. The primary outcome was the proportion of patients who developed hypoxia (SpO2 < 90%). The secondary outcomes included subclinical respiratory depression (90% ≤ SpO2 < 95%), severe hypoxemia (SpO2 < 75%), airway interventions, adverse events, hemodynamics, propofol dosage, and procedure time. The certainty of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Twelve trials (n = 3058) were included in the analysis. The evidence suggests that SJOV results in a large reduction in the risk of hypoxemia (risk ratio [RR], 0.26; 95% confidence interval, 0.19–0.36; low certainty) and subclinical respiratory depression (RR, 0.40; low certainty) compared with the control. SJOV likely resulted in a large reduction in the risk of severe hypoxemia (RR, 0.22; moderate certainty). In addition, it may result in a large reduction in the need for jaw lift (RR, 0.22; low certainty) and mask ventilation (RR, 0.13; low certainty). The risk of sore throat probably increases with SJOV (RR, 1.71; moderate certainty), whereas SJOV may result in little to no difference in nasal bleeding (RR, 1.75; low certainty). Evidence is very uncertain regarding the effect of SJOV on hemodynamics (very low certainty) and procedure time (very low certainty). SJOV probably resulted in little to no difference in sedative doses between the groups (moderate certainty). Conclusion According to the GRADE approach, SJOV likely results in a large reduction in the risk of severe hypoxemia but probably increases the risk of sore throat. Compared with the control, evidence suggests that SJOV results in a large reduction in the risk of hypoxemia, subclinical respiratory depression, and the need for airway manipulation, with little to no difference in nasal bleeding. The integration of SJOV into clinical practice may help minimize hypoxemic events in at-risk patients.https://doi.org/10.1186/s13643-024-02707-wSupraglottic jet oxygenation and ventilationHypoxemiaSedationPropofolWei nasal jet tube |
| spellingShingle | I-Wen Chen Wei-Ting Wang Pei-Chun Lai Chun-Ning Ho Chien-Ming Lin Yao-Tsung Lin Yen-Ta Huang Kuo-Chuan Hung Efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approach Systematic Reviews Supraglottic jet oxygenation and ventilation Hypoxemia Sedation Propofol Wei nasal jet tube |
| title | Efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approach |
| title_full | Efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approach |
| title_fullStr | Efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approach |
| title_full_unstemmed | Efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approach |
| title_short | Efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approach |
| title_sort | efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation related hypoxemia a meta analysis with grade approach |
| topic | Supraglottic jet oxygenation and ventilation Hypoxemia Sedation Propofol Wei nasal jet tube |
| url | https://doi.org/10.1186/s13643-024-02707-w |
| work_keys_str_mv | AT iwenchen efficacyandsafetyofsupraglotticjetoxygenationandventilationtominimizesedationrelatedhypoxemiaametaanalysiswithgradeapproach AT weitingwang efficacyandsafetyofsupraglotticjetoxygenationandventilationtominimizesedationrelatedhypoxemiaametaanalysiswithgradeapproach AT peichunlai efficacyandsafetyofsupraglotticjetoxygenationandventilationtominimizesedationrelatedhypoxemiaametaanalysiswithgradeapproach AT chunningho efficacyandsafetyofsupraglotticjetoxygenationandventilationtominimizesedationrelatedhypoxemiaametaanalysiswithgradeapproach AT chienminglin efficacyandsafetyofsupraglotticjetoxygenationandventilationtominimizesedationrelatedhypoxemiaametaanalysiswithgradeapproach AT yaotsunglin efficacyandsafetyofsupraglotticjetoxygenationandventilationtominimizesedationrelatedhypoxemiaametaanalysiswithgradeapproach AT yentahuang efficacyandsafetyofsupraglotticjetoxygenationandventilationtominimizesedationrelatedhypoxemiaametaanalysiswithgradeapproach AT kuochuanhung efficacyandsafetyofsupraglotticjetoxygenationandventilationtominimizesedationrelatedhypoxemiaametaanalysiswithgradeapproach |