Effects of sniffing position for tracheal intubation: A meta-analysis of randomized controlled trials

Yuki Akihisa, Hiroshi Hoshijima, Koichi Maruyama, Yukihide Koyama, Tomio Andoh

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Background The purpose of this meta-analysis was to validate the efficacy of the sniffing position in the performance of intubation with direct laryngoscopy. Methods We searched MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and Web of Science. Six randomized controlled trials comprising 2759 adult participants were analyzed. The DerSimonian-Laird method was used to calculate pooled relative risk (RR) and the 95% confidence interval (CI) of Cormack-Lehane classification, Intubation Difficulty Scale, success rate of the first intubation, and weighted mean difference of intubation time. Results Compared with the other head positions, the sniffing position did not improve glottic visualization, success rate of the first intubation, or intubation time. However, the sniffing position was significantly associated with better Intubation Difficulty Scale compared with the simple head extension position. (RR,1.28; 95% CI, 1.15-1.42; p < 0.0001) Conclusions Although patients do not benefit from the sniffing position in terms of glottic visualization, success rate of the first intubation, or intubation time, the sniffing position can still be recommended as the initial head position for tracheal intubation because the sniffing position provides easier intubation conditions.

Original languageEnglish
Pages (from-to)1606-1611
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume33
Issue number11
DOIs
Publication statusPublished - 2015 Nov

ASJC Scopus subject areas

  • Emergency Medicine

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