Evidence map›Paper›PMID 40542093›Full record

SynthesisPediatric research2026

Adverse events in pediatric orotracheal intubation in the pediatric emergency department: systematic review and meta-analysis.

Mohammed Alsabri, Ibrahim Kamal, Mohammed Al-Tawil, Eshak I Bahbah, Alaa Ahmed Elshanbary, Mohamed Sayed Zaazouee, Aroosa Zamarud, Abdullah S Binsaeedu, Muhammad Usman Shahbaz, Janu Chhetri

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Pediatric research, 2026. 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. Article
  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

10 authors.

Mohammed AlsabriEmergency Department, AL-thawra Modern General Hospital, Sana'a, Yemen. alsabri5000@gmail.com.
Ibrahim KamalFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohammed Al-TawilDepartment of Cardiac and Thoracic Surgery, Heart Centre Trier, Trier, Germany.
Eshak I BahbahFaculty of Medicine, Al-Azhar University, Damietta, Egypt.
Alaa Ahmed ElshanbaryFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Mohamed Sayed ZaazoueeFaculty of Medicine, Al-Azhar University, Assiut, Egypt.
Aroosa ZamarudDepartment of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
Abdullah S BinsaeeduAlfaisal University, Riyadh, Saudi Arabia.
Muhammad Usman ShahbazAllama Iqbal Medical College, Lahore, Pakistan.
Janu ChhetriFatima Jinnah Medical University, Lahore, Pakistan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aims to systematically review all adverse events (AEs) associated with orotracheal intubation in pediatric patients, with the ultimate goal of aiding healthcare center administration in establishing evidence-based guidelines and devising preventive strategies to mitigate AEs in pediatric intubation procedures.

methodsSystematic automated searches across pivotal databases were conducted up to 2023. The screening process was facilitated by EndNote X9 following the importation of citations. Data extraction was guided by predefined eligibility criteria after the elimination of duplicates and ineligible publications. The National Institutes of Health (NIH) quality evaluation instrument was employed to assess biases.

resultsA total of twenty-four studies spanning from 2002 to 2023, encompassing 7135 patients were included in the analysis. Among the identified adverse events, moderate desaturation(≤90%) emerged as the most prevalent, affecting 508/2398 (23.9%, 95% CI: 17.6% to 30.3%) of cases across 13 studies. Mainstem intubation was observed in 342 out of 4,481 cases (9.1%, 95% CI: 6.3% to 11.9%) and in 173 out of 3903 cases (3.9%, 95% CI: 2.5% to 5.3%), making these significant AEs. Cardiac complications, including arrhythmias 55/3858 (1.2%, 95% CI: 0.6% to 1.8%), hypotension 121/4536 (2.6%, 95% CI: 1.5% to 3.7%), and cardiac arrest 105/4836 (1.4%, 95% CI: 0.7% to 2.2%), were observed in 10, 11, and 11 trials, respectively. Severe complications, with an incidence rate of 274/3298 (8.8%, 95% CI: 4.2% to 13.3%), were reported in five studies.

conclusionThis comprehensive investigation and subsequent meta-analysis of adverse events associated with pediatric intubation provide valuable insights that can inform the development of enhanced safety protocols and evidence-based guidelines for pediatric emergency care. IMPACT: High Success Rate with Complications: An 84.7% intubation success rate is reported, with a 30.1% complication rate, including desaturation, mainstem and esophageal intubation, and cardiac issues. Need for Enhanced Safety Measures: Findings stress the importance of better training and standardized protocols to reduce complications in pediatric emergency intubation. Focus on Adverse Events: This study uniquely highlights adverse events, offering crucial data for developing guidelines to improve safety in pediatric intubation.

Indexed as

Emergency Service, HospitalIntubation, IntratrachealPediatricsChildChild, PreschoolHumansInfant

Identifiers

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Registered trials

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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.