Evidence map›Paper›PMID 39966725›Full record

SynthesisBMC anesthesiology2025

Guideline recommendations on the assessment and management of awake airway intubation: a systematic review.

Fei Chen, Zhimin Tan, Qiyu He, Qian Li

Abstract readSystematic Review
In one paragraph

Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Ten tips for a safe approach in airway management.Journal of anesthesia, analgesia and critical care · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Fei Chen *Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Zhimin Tan *Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Qiyu HeDepartment of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Qian LiDepartment of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. hxliqian@wchscu.cn.

Funding

Sichuan Provincial Science and Technology Support Program 2023ZYD0168
6 · The paper itself

Abstract

objectivesTo systematically appraise the quality of clinical practice guidelines (CPGs) regarding awake tracheal intubation (ATI) and to compare the consistency of common recommendations.

designSystematic review, critical appraisal and narrative synthesis of CPG recommendations for ATI.

methodsA systematic search of the PubMed, EMBASE, Cochrane, Web of Science, and Scopus databases was conducted up to July 1, 2024, to identify up-to-date CPGs. The AGREE II (Appraisal of Guidelines for Research and Evaluation) checklist was used to critically appraise the CPGs. Interrater agreement was determined via intraclass correlation coefficients (ICCs) with a two-way random effects model for each domain and overall rating score. All the suggestions extracted from the included guidelines were sorted and analyzed and summarized via the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.

resultsOur study resulted in 939 records and ultimately 7 CPGs were appraised. The content of these CPGs covered six themes of ATI: indications, airway local anesthesia, the intubation procedure, checking the tube position, management after ATI failure, and the extubation process. When the AGREE II tool was used to appraise CPGs, only 3 CPGs were rated as "high" quality. With the exception of domain 1, we observed good agreement in all five other domains (ICCs over 0.7). These CPGs provided relatively consistent recommendations and evidence on intubation procedures and checking tube position. In terms of indications and airway local anesthesia, there was controversy. Twenty-nine recommendations regarding ATI were summarized through the GRADE system, among which 16 were considered relatively reliable.

conclusionThrough the AGREE II tool and the GRADE system, the strengths and weaknesses of each CPG were comprehensively analyzed on the basis of its scientific validity and practicability. Moreover, the limitations of the current CPGs in terms of indications, airway local anesthesia and complex clinical situations are presented, and clinicians are encouraged to apply the guidelines more scientifically and to update and improve the guidelines. SYSTEMATIC REVIEW REGISTRATION: CRD4202458548 (PROSPERO).

Indexed as

Airway ManagementIntubation, IntratrachealPractice Guidelines as TopicHumansWakefulnessAGREE II (Appraisal of guidelines for research and evaluation)Awake tracheal intubation (ATI)Clinical practice guidelines (CPGs)GRADE (grading of recommendations assessment development and evaluation)Intraclass correlation coefficient (ICC)Systematic review

Identifiers

PMID39966725
PMCPMC11834173

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.