Vanderhal Andre L, Berci George, Simmons Charles F, Hagiike Masanobu
Department of Pediatrics, Division of Neonatology, Minimally Invasive Surgery Research, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Pediatrics. 2009 Aug;124(2):e339-46. doi: 10.1542/peds.2008-3653. Epub 2009 Jul 20.
We describe videolaryngoscopy equipment and technique for endotracheal intubation and airway evaluation in the delivery room (DR) and NICU for endotracheal intubation and airway evaluation. We report our first experience of 47 patients.
Forty-seven infants who weighed 530 to 6795 g and required endotracheal intubation or airway evaluation were considered for intubation or assessment by using the modified Kaplan-Berci videolaryngoscope. We report quality-improvement data after initial introduction of newly approved technology.
We report results of 48 intubations in 42 patients and videolaryngoscopic inspection without intubation in 5 patients. Five intubation attempts were successful after failed attempts by experienced intubators; 6 attempts by residents were completed with video guidance rather than requiring an additional attempt. Only 3 intubations required more than 2 attempts. Enlarged panoramic view and recording assisted in correct diagnosis of vocal cord paralysis. The features and main advantages are discussed in detail. No complications or difficulties resulting from the technology occurred.
This new technique and technology show promise to improve airway management, evaluation, and teaching. Future research to validate improved intubation success in difficult airways and in teaching situations is warranted.
我们描述了用于产房（DR）和新生儿重症监护病房（NICU）气管插管及气道评估的视频喉镜设备和技术。我们报告了47例患者的首次使用经验。
47例体重在530至6795克之间且需要气管插管或气道评估的婴儿被纳入研究，使用改良的Kaplan - Berci视频喉镜进行插管或评估。我们报告了新批准技术首次引入后的质量改进数据。
我们报告了42例患者的48次插管结果以及5例未进行插管的视频喉镜检查结果。5次插管尝试在经验丰富的插管人员失败后成功；住院医师的6次尝试在视频引导下完成，无需额外尝试。只有3次插管需要超过2次尝试。放大的全景视图和记录有助于正确诊断声带麻痹。详细讨论了其特点和主要优点。该技术未引发任何并发症或困难。
这项新技术有望改善气道管理、评估和教学。未来有必要进行研究以验证在困难气道和教学场景中插管成功率的提高。
