Neuromuscular blocking agents for tracheal intubation of critically ill adults: a systematic review and meta-analysis.
Pedro Vitale Mendes, Ian Ward Abdalla Maia, Rafael von Hellmann et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the impact of neuromuscular blocking agents (NMBAs) on first-attempt success rates and adverse events during emergency intubations in critically ill adults. The analysis included 13 studies with 14,072 participants. NMBA use was linked to a higher first-attempt success rate, with a pooled odds ratio of 2.72 (95% CI: 1.42-5.21).
Key findings
- NMBA use improved first-attempt success rates, ranging from 69% to 92%.
- The pooled odds ratio for first-attempt success with NMBA was 2.72.
- Secondary outcomes related to adverse events had very low certainty due to data limitations.
Why it matters
Improving first-attempt success during emergency intubation is crucial for patient safety, particularly in critically ill adults. Understanding the role of NMBAs can inform clinical decision-making in high-risk situations.
What to keep in mind
The certainty of evidence regarding adverse events was rated very low due to sparse data and inconsistent reporting.