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dc.contributor.author
Ciapponi, Agustín  
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Perelli, Lucas  
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Cohen Arazi, Hernán  
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Solioz, Germán  
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Bardach, Ariel Esteban  
dc.date.available
2023-09-20T18:32:15Z  
dc.date.issued
2021-09  
dc.identifier.citation
Ciapponi, Agustín; Perelli, Lucas; Cohen Arazi, Hernán; Solioz, Germán; Bardach, Ariel Esteban; Overview of evidence-based clinical practice guidelines for difficult airway management in adults: a systematic review; BioMed Central; Systematic Reviews; 9-2021; 1-13  
dc.identifier.issn
2046-4053  
dc.identifier.uri
http://hdl.handle.net/11336/212410  
dc.description.abstract
Background : The aim of the clinical practice guidelines (CPGs) in the management of difficult airway is to provide optimal responses to a potentially life-threatening clinical problem.Objective : to summarize and compare relevant recommendations and algorithms from evidence-based CPGs (EB-CPGs).Methods : We conducted a systematic review (overview) of CPGs, following Cochrane methods. We summarized recommendations, its supporting evidence and strength of recommendations according to the GRADE methodology. In July 2018, we searched CPGs that were published in the last 10 years, without language restrictions, in electronic databases, and searched specific CPG sources, reference lists and consulted experts. We searched PubMed, EMBASE, Cochrane Library, LILACS, Tripdatabase and additional sources. Pairs of independent reviewers selected EB-CPGs and rated their methodological quality using the AGREE-II instrument. We included those EB-CPGs reporting standard methods for identification, data collection, study risk of bias assessment and recommendations’ level of evidence. Discrepancies were solved by consensus.Results: We included 11 EB-CPGs out of 2505 references identified in literature searches within the last ten years. Only three of them used the GRADE system. The domains with better performance in the AGREE-II assessment, were ‘adequate description of scoping’ and ‘objectives’ while those with worst performance were ‘‘Guidelines’ applicability’ and ‘monitoring’. As a result, only three EB-CPGs were classified as ‘Highly recommended, two as ‘Recommended’ and six as ‘Not recommended. We summarized 22 diagnostic recommendations, 22% of which were supported by high/moderate quality of evidence (41% of them were considered by developers as strong recommendations), and 16 therapeutic/preventive recommendations, 59% of which were supported by high/moderate quality of evidence (76% strong). Only half of the EB-CPGs were updated in the past five years.Conclusions : The main EB-CPGs in the management of difficult airway in anesthesia presented significant heterogeneity in terms of their quality and system of grading the evidence and strength of recommendation used, and most used their own systems. We present many strong recommendations that are ready to be considered for implementation, and we reveal opportunities to improve guidelines’ quality.  
dc.format
application/pdf  
dc.language.iso
eng  
dc.publisher
BioMed Central  
dc.rights
info:eu-repo/semantics/openAccess  
dc.rights.uri
https://creativecommons.org/licenses/by/2.5/ar/  
dc.subject
Internal Medicine  
dc.subject
Difficult airway  
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Intubation  
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Clinical Practice Guidelines  
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Systematic review  
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GRADE  
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AGREE-II  
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Otras Ciencias de la Salud  
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Ciencias de la Salud  
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CIENCIAS MÉDICAS Y DE LA SALUD  
dc.title
Overview of evidence-based clinical practice guidelines for difficult airway management in adults: a systematic review  
dc.type
info:eu-repo/semantics/article  
dc.type
info:ar-repo/semantics/artículo  
dc.type
info:eu-repo/semantics/publishedVersion  
dc.date.updated
2023-09-18T13:28:26Z  
dc.journal.pagination
1-13  
dc.journal.pais
Reino Unido  
dc.journal.ciudad
Londres  
dc.description.fil
Fil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina  
dc.description.fil
Fil: Perelli, Lucas. Instituto de Efectividad Clínica y Sanitaria; Argentina  
dc.description.fil
Fil: Cohen Arazi, Hernán. Instituto de Efectividad Clínica y Sanitaria; Argentina  
dc.description.fil
Fil: Solioz, Germán. Instituto de Efectividad Clínica y Sanitaria; Argentina  
dc.description.fil
Fil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina  
dc.journal.title
Systematic Reviews  
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/https://doi.org/10.21203/rs.3.rs-441504/v1  
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://www.researchsquare.com/article/rs-441504/v1