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dc.contributor.authorBooth AWGen_US
dc.contributor.authorPungsornruk Ken_US
dc.contributor.authorLlewellyn Sen_US
dc.contributor.authorSturgess Den_US
dc.contributor.authorVidhani Ken_US
dc.description.abstractAbstract Background: Adult epiglottitis is a life-threatening airway emergency where airway protection is the immediate priority. Despite its importance, the optimal approach to airway management remains unclear. We performed a systematic review of the airway management for adult epiglottitis, including meta-analysis of trends over time. Methods: We systematically searched PubMed, Ovid MEDLINE®, and Embase® for adult epiglottitis studies that described the airway management between 1980 and 2020. The primary outcome was the prevalence of airway intervention. Secondary outcomes were prevalence of tracheal intubation, tracheostomy, and failed intubation. A random-effects model meta-analysis was performed with subgroups defined by decade of study publication. Cases that described the specific method of airway intervention and severity of epiglottitis were included in a separate technique summary. Results: Fifty-six studies with 10 630 patients were included in the meta-analysis. The overall rate of airway intervention was 15.6% (95% confidence interval [CI] 12.9-18.8%) but the rate decreased from 20% to 10% between 1980 and 2020. The overall rate of tracheal intubation was 10.2% (95% CI 7.1-13.6%) and that of failed intubation was 4.2% (95% CI 1.4-8.0%). The airway technique summary included 128 cases, of which 75 (58.6%) were performed awake and 53 (41.4%) involved general anaesthesia. We identified 32 cases of primary technique failure. Conclusion: The rate of airway intervention for adult epiglottitis has decreased over four decades to a current level of 10%. Tracheal intubation is a high-risk scenario with a 1 in 25 failure rate. Specific technique selection is most likely influenced by contextual factors including the severity of epiglottitis. Keywords: adult epiglottitis; airway intervention; epiglottitis; intubation; tracheostomy.en_US
dc.subjectadult epiglottitisen_US
dc.subjectairway interventionen_US
dc.subjectintubation; tracheostomyen_US
dc.titleAirway management of adult epiglottitis: a systematic review and meta-analysisen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleBJA Openen_US
dc.description.affiliatesDepartment of Anaesthesia, Princess Alexandra Hospital - Southern Clinical School, Faculty of Medicine, The University of Queensland, Brisbane, Australia.en_US
dc.description.affiliatesDepartment of Anaesthesia, Princess Alexandra Hospital, Brisbane, Australia.en_US
dc.description.affiliatesStatistics Unit, QIMR Berghofer Institute of Medical Research, Brisbane, Australia.en_US
dc.description.affiliatesThe University of Queensland (UQ) and Surgical Treatment and Rehabilitation Service (STARS), Brisbane, Australia.en_US
dc.type.studyortrialSystematic Reviewsen_US
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
Appears in Collections:Scholarly and Clinical
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