A systematic review on suction-based airway clearance devices for foreign body airway obstruction
Miguel Angel Paludi, Natalino Palermo, Francesco Limonti, A. Semeraro, Daniele Ermanno, Sandro Ganzino, Nicola Ramacciati
Abstract
• Complete airway obstructions by foreign bodies, if untreated, are life-threatening and carry a high risk of mortality. • Currently, there are devices available on the market for airway obstruction management. • Numerous recent studies are investigating the efficacy of these devices. • Training is crucial for the effective use of anti-choking devices. • Despite promising results, further research is necessary to confirm their effectiveness. The objective of this systematic review is to comprehensively evaluate the effectiveness and safety of negative pressure, anti-choking devices (ACDs) in managing severe foreign body airway obstructions (FBAO) compared to traditional techniques such as the Heimlich maneuver. A comprehensive literature search was conducted in major databases to identify studies published within the past five years. Eligible studies were appraised for quality using the Critical Appraisal and Data Extraction Tool. Data on study design, outcomes, and safety parameters were extracted and analyzed. The review identified studies evaluating various ACDs, including LifeVac and DeChoker, in different settings and populations. Results from retrospective studies and trials on mannequins or cadavers suggested promising outcomes for ACDs in relieving FBAO, with success rates ranging from 71% to 99%. However, concerns regarding usability, training, and adverse events were raised, emphasizing the need for further research. Review emphasizes traditional maneuvers (thrusts/blows) for all rescuers. ACDs show promise, but further research is needed to determine their role alongside established methods. LifeVac’s design may offer advantages in terms of ease of use, potentially requiring less dexterity compared to Dechoker. Regardless of the device, proper training remains crucial for optimal effectiveness and safe use. Combining ACDs with traditional methods like abdominal thrusts and back blows may be a promising approach for improving airway obstruction management.