Wiese Christoph H R, Bartels Utz, Schultens Alexander, Steffen Tobias, Torney Andreas, Bahr Jan, Graf Bernhard M
Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany.
J Emerg Med. 2011 Aug;41(2):128-34. doi: 10.1016/j.jemermed.2008.08.014. Epub 2009 Feb 13.
In 2005, the European Resuscitation Council and the American Heart Association published new guidelines for Advanced Life Support. One of the points was to reduce the time without chest compressions in the first phase of cardiac arrest.
We evaluated in a manikin model whether using the single-use laryngeal tube with suction option (LTS-D) instead of endotracheal intubation (ET) and bag-mask-valve ventilation (BMV) for emergency airway management could reduce the "no-flow time" (NFT). The NFT is defined as the time during resuscitation when no chest compressions take place.
A randomized, prospective study was undertaken with 150 volunteers who performed management of a standardized simulated cardiac arrest in a manikin. Every participant was randomized to one of three different airway management groups (LTS-D vs. ET vs. BMV).
The LTS-D was inserted significantly faster than the ET tube (15 s vs. 44 s, respectively, p < 0.01). During the cardiac arrest simulation, establishing and performing ventilation took an average of 57 s with the LTS-D compared to 116 s with ET and 111 s with the BMV. Using the LTS-D significantly reduced NFT compared to ET and the BMV (125 s vs. 207 s vs. 160 s; p < 0.01).
In our manikin study, NFT was reduced significantly when the LTS-D was used when compared to ET and BMV. The results of our manikin study suggest that for personnel not experienced in tracheal intubation, the LTS-D offers a good alternative to ET and BMV to manage the airway during resuscitation, and to avoid the failure to achieve tracheal intubation with the ET, and the failure to achieve adequate ventilation with the BMV.
2005年,欧洲复苏委员会和美国心脏协会发布了高级生命支持的新指南。其中一点是减少心脏骤停第一阶段无胸外按压的时间。
我们在人体模型中评估,对于紧急气道管理,使用带有吸引功能的一次性喉管(LTS-D)而非气管插管(ET)和袋-面罩-通气(BMV)是否能减少“无血流时间”(NFT)。NFT定义为复苏过程中不进行胸外按压的时间。
对150名志愿者进行了一项随机、前瞻性研究,他们在人体模型中进行标准化模拟心脏骤停的管理。每位参与者被随机分配到三个不同的气道管理组之一(LTS-D组与ET组与BMV组)。
LTS-D的插入速度明显快于ET管(分别为15秒和44秒,p<0.01)。在心脏骤停模拟过程中,使用LTS-D建立和进行通气平均耗时57秒,而ET组为116秒,BMV组为111秒。与ET和BMV相比,使用LTS-D显著减少了NFT(125秒对207秒对160秒;p<0.01)。
在我们的人体模型研究中,与ET和BMV相比,使用LTS-D时NFT显著减少。我们人体模型研究的结果表明,对于没有气管插管经验的人员,LTS-D为复苏期间气道管理提供了一个很好的替代ET和BMV的方法,避免了ET气管插管失败以及BMV通气不足的情况。