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["喉管-D(LT-D)和喉罩(LMA)"]

["Laryngeal Tube-D" (LT-D) and "Laryngeal Mask" (LMA)].

作者信息

Wiese C H R, Bahr J, Graf B M

机构信息

Zentrum für Anaesthesiologie, Rettungs- und Intensivmedizin, Georg-August Universität Göttingen.

出版信息

Dtsch Med Wochenschr. 2009 Jan;134(3):69-74. doi: 10.1055/s-0028-1105889. Epub 2008 Dec 12.

Abstract

BACKGROUND AND OBJECTIVES

In 2005 the European Resuscitation Council (ERC) published a revised version of the guidelines for Advanced Life Support (ALS). One of the aims was to reduce the time without chest compression in the first period of cardiac arrest. We evaluated in a manikin study whether using the single use laryngeal tube (LT-D) instead of single use laryngeal mask (LMA) for emergency airway management could reduce the "No Flow Time" (NFT). The NFT is defined as the time during which no chest compressions take place.

METHODS

Randomised prospective study with 200 volunteers who performed a standardised simulated cardiac arrest management in a manikin following one-day cardiac arrest training (simulation scenario 430 s). Two supraglottic airway devices were compared (LT-D and LMA). Endpoints were the total "no flow time" during the scenario, and the successful airway management with the used airway device.

RESULTS

In the present manikin study the use of the LT-D significantly reduced NFT compared with the LMA (104.2 s vs. 124.0 s; p < 0.01). The LT-D was correctly positioned by 98 % of the participants on the first attempt compared to 74 % with the LMA. The LT-D was inserted significantly faster than the LMA (12.4 s vs. 29.1 s, p < 0.01). During the cardiac arrest simulation establishing and performing first ventilation took an average of 40.5 s with the LT-D compared to 47.9 s with LMA.

CONCLUSIONS

In this manikin study data showed that the LT-D may be a good alternative airway device compared to LMA for providing and maintaining a patent airway during resuscitation.

摘要

背景与目的

2005年欧洲复苏委员会(ERC)发布了高级生命支持(ALS)指南的修订版。目标之一是减少心脏骤停初期无胸外按压的时间。我们在一项人体模型研究中评估,对于紧急气道管理,使用一次性喉管(LT-D)而非一次性喉罩(LMA)是否能减少“无血流时间”(NFT)。NFT定义为未进行胸外按压的时间。

方法

对200名志愿者进行随机前瞻性研究,这些志愿者在接受一天的心脏骤停培训后(模拟场景430秒),在人体模型上进行标准化的模拟心脏骤停管理。比较两种声门上气道装置(LT-D和LMA)。终点指标为场景中的总“无血流时间”,以及使用的气道装置进行气道管理的成功率。

结果

在当前的人体模型研究中,与LMA相比,LT-D的使用显著减少了NFT(104.2秒对124.0秒;p<0.01)。98%的参与者首次尝试时LT-D定位正确,而LMA为74%。LT-D的插入速度明显快于LMA(12.4秒对29.1秒,p<0.01)。在心脏骤停模拟过程中,使用LT-D建立并进行首次通气平均用时40.5秒,而使用LMA为47.9秒。

结论

在这项人体模型研究中,数据表明与LMA相比,LT-D在复苏期间提供和维持气道通畅方面可能是一种良好的替代气道装置。

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