RESUMO
Videolaryngoscopes are thought to improve glottic view and facilitate tracheal intubation compared with the Macintosh direct laryngoscope. However, we currently do not know which one would be the best choice in most patients undergoing anaesthesia. We designed this systematic review with network meta-analyses to rank the different videolaryngoscopes and the Macintosh direct laryngoscope. We conducted searches in PubMed and a further five databases on 11 January 2021. We included randomised clinical trials with patients aged ≥16 years, comparing different videolaryngoscopes, or videolaryngoscopes with the Macintosh direct laryngoscope for the outcomes: failed intubation; failed first intubation attempt; failed intubation within two attempts; difficult intubation; percentage of glottic opening seen; difficult laryngoscopy; and time needed for intubation. We assessed the quality of evidence according to GRADE recommendations and included 179 studies in the meta-analyses. The C-MAC and C-MAC D-Blade were top ranked for avoiding failed intubation, but we did not find statistically significant differences between any two distinct videolaryngoscopes for this outcome. Further, the C-MAC D-Blade performed significantly better than the C-MAC Macintosh blade for difficult laryngoscopy. We found statistically significant differences between the laryngoscopes for time to intubation, but these differences were not considered clinically relevant. The evidence was judged as of low or very low quality overall. In conclusion, different videolaryngoscopes have differential intubation performance and some may be currently preferred among the available devices. Furthermore, videolaryngoscopes and the Macintosh direct laryngoscope may be considered clinically equivalent for the time taken for tracheal intubation. However, despite the rankings from our analyses, the current available evidence is not sufficient to ensure significant superiority of one device or a small set of them over the others for our intubation-related outcomes.
Assuntos
Intubação Intratraqueal/métodos , Laringoscopia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Técnicas e Procedimentos Assistidos por Vídeo , Adulto , Humanos , Intubação Intratraqueal/normas , Laringoscopia/normas , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto/normasAssuntos
Alopecia/patologia , Dermatoses do Couro Cabeludo/patologia , Adulto , Idoso , Feminino , Testa , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
A method for determination of some triazine residues in water has been developed. The method involves concentration with C18 solid-phase extraction cartridges followed by high-performance liquid chromatographic analysis using a C18 column with UV detection at 230 nm, a mobile phase of methanol-water (60:40, v/v) at pH 4.6 (phosphoric acid) and a flow-rate of 0.8 ml/min. After optimization of the extraction and separation conditions, the method was validated. The method can be used for determination of atrazine, simazine, cyanazine and ametryn in water, within the international limits of 0.1 microg/l.
Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Triazinas/análise , Poluentes Químicos da Água/análise , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Espectrofotometria UltravioletaRESUMO
A method for determination of bentazon residues in water has been developed. The method involves solid-phase extraction with C18 extraction tubes and high-performance liquid chromatographic analysis. A C18 column and guard column were used with UV detection at 230 nm, a mobile phase of methanol-water (60:40, v/v) at pH 4.6 (phosphoric acid) and a flow-rate of 0.8 ml/min. After optimization of the extraction and separation conditions, the method was validated. The method developed can be used for determination of bentazon in water, within the international limits of 0.1 microgram/l, with a 500-fold pre-concentration.