The following is a summary of “A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Supine vs. Nonsupine Endotracheal Intubation,” published in the July 2023 issue of Critical Care by Mashina et al.

Researchers performed a retrospective study to compare intubation safety and efficacy between supine and nonsupine positions. Thirteen studies comparing nonemergent intubation in supine and non supine positions were selected using PRISMA and MOOSE protocols until October 2020.

They calculated pooled estimates with 95% CI using random-effects models. Primary outcomes were successful intubation, attempts, and duration, while secondary outcomes included adverse events (trauma and hypoxia). Bias was assessed visually and quantitatively using the Egger test. The analysis covered 13 clinical trials involving 1,916 patients. Success rates for supine vs. lateral positions were 99.21% and 98.82%, and for supine vs. semierect positions were 99.21% and 98.82%. The first attempt success rate for supine vs. lateral was 85.35% and 88.56%, and for supine vs. semierect was 91.38% and 90.76%. Total adverse events were 3.73% in supine vs. 6.74% in lateral and 0.44% in supine vs. 0.93% in semierect. The result showed varying degrees of heterogeneity.

The study concluded no significant difference in successful intubations or first-attempt success between supine and nonsupine positions. Slightly higher adverse events in nonsupine. Further research is needed.

Source: hindawi.com/journals/ccrp/2023/5496368/