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Rocuronium versus succinylcholine for rapid sequence induction intubation

Overview of attention for article published in Cochrane database of systematic reviews, October 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

blogs
4 blogs
twitter
122 tweeters
facebook
1 Facebook page
wikipedia
1 Wikipedia page
googleplus
2 Google+ users

Citations

dimensions_citation
54 Dimensions

Readers on

mendeley
218 Mendeley
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Title
Rocuronium versus succinylcholine for rapid sequence induction intubation
Published in
Cochrane database of systematic reviews, October 2015
DOI 10.1002/14651858.cd002788.pub3
Pubmed ID
Authors

Diem TT Tran, Ethan K Newton, Victoria AH Mount, Jacques S Lee, George A Wells, Jeffrey J Perry

Abstract

Patients often require a rapid sequence induction (RSI) endotracheal intubation technique during emergencies or electively to protect against aspiration, increased intracranial pressure, or to facilitate intubation. Traditionally succinylcholine has been the most commonly used muscle relaxant for this purpose because of its fast onset and short duration; unfortunately, it can have serious side effects. Rocuronium has been suggested as an alternative to succinylcholine for intubation. This is an update of our Cochrane review published first in 2003 and then updated in 2008 and now in 2015. To determine whether rocuronium creates intubating conditions comparable to those of succinylcholine during RSI intubation. In our initial review we searched all databases until March 2000, followed by an update to June 2007. This latest update included searching the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 2), MEDLINE (1966 to February Week 2 2015), and EMBASE (1988 to February 14 2015 ) for randomized controlled trials (RCTs) or controlled clinical trials (CCTs) relating to the use of rocuronium and succinylcholine. We included foreign language journals and handsearched the references of identified studies for additional citations. We included any RCT or CCT that reported intubating conditions in comparing the use of rocuronium and succinylcholine for RSI or modified RSI in any age group or clinical setting. The dose of rocuronium was at least 0.6 mg/kg and succinylcholine was at least 1 mg/kg. Two authors (EN and DT) independently extracted data and assessed methodological quality for the 'Risk of bias' tables. We combined the outcomes in Review Manager 5 using a risk ratio (RR) with a random-effects model. The previous update (2008) had identified 53 potential studies and included 37 combined for meta-analysis. In this latest update we identified a further 13 studies and included 11, summarizing the results of 50 trials including 4151 participants. Overall, succinylcholine was superior to rocuronium for achieving excellent intubating conditions: RR 0.86 (95% confidence interval (CI) 0.81 to 0.92; n = 4151) and clinically acceptable intubation conditions (RR 0.97, 95% CI 0.95 to 0.99; n = 3992, 48 trials). A high incidence of detection bias amongst the trials coupled with significant heterogeneity provides moderate-quality evidence for these conclusions, which are unchanged from the previous update. Succinylcholine was more likely to produce excellent intubating conditions when using thiopental as the induction agent: RR 0.81 (95% CI: 0.73 to 0.88; n = 2302, 28 trials). In the previous update, we had concluded that propofol was the superior induction agent with succinylcholine. There were no reported incidences of severe adverse outcomes. We found no statistical difference in intubation conditions when succinylcholine was compared to 1.2 mg/kg rocuronium; however, succinylcholine was clinically superior as it has a shorter duration of action. Succinylcholine created superior intubation conditions to rocuronium in achieving excellent and clinically acceptable intubating conditions.

Twitter Demographics

The data shown below were collected from the profiles of 122 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 218 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 3 1%
Colombia 2 <1%
Australia 1 <1%
Canada 1 <1%
Mexico 1 <1%
United States 1 <1%
Unknown 209 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 33 15%
Other 32 15%
Student > Bachelor 29 13%
Student > Postgraduate 23 11%
Researcher 18 8%
Other 57 26%
Unknown 26 12%
Readers by discipline Count As %
Medicine and Dentistry 151 69%
Nursing and Health Professions 18 8%
Pharmacology, Toxicology and Pharmaceutical Science 4 2%
Unspecified 2 <1%
Biochemistry, Genetics and Molecular Biology 2 <1%
Other 9 4%
Unknown 32 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 108. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 December 2019.
All research outputs
#159,070
of 14,162,689 outputs
Outputs from Cochrane database of systematic reviews
#340
of 10,869 outputs
Outputs of similar age
#4,700
of 284,065 outputs
Outputs of similar age from Cochrane database of systematic reviews
#13
of 255 outputs
Altmetric has tracked 14,162,689 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,869 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.7. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 284,065 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 255 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.