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ETView 经皮肾镜取石术后用于监测管位置的气管镜通气管。

ETView tracheoscopic ventilation tube for surveillance after tube position in patients undergoing percutaneous nephrolithotomy.

机构信息

Department of Anesthesiology, Rambam Health Care Campus, Haifa, Israel.

出版信息

Br J Anaesth. 2010 Apr;104(4):501-4. doi: 10.1093/bja/aeq024. Epub 2010 Feb 25.

Abstract

BACKGROUND

Tracheal tube (TT) displacement during general anaesthesia may result in life-threatening complications and continuous direct vision of the position of the tube may enable safer management. The ETView tracheoscopic ventilation tube (TVT) is a single-use TT incorporating a video camera and a light source in its tip. The view from the tip appears continuously on a portable monitor in the anaesthetist's vicinity. This study was designed to test the ETView TVT in monitoring the TT position during general anaesthesia.

METHODS

In this prospective study, the ETView TVT was used to ventilate the lungs of 30 adult patients undergoing percutaneous nephrolithotomy (PCNL), which required changing patient position three times. During surgery, the anaesthetist followed the carinal view on the ETView TVT portable monitor. Tube movement within 1 cm was recorded, as was the need for repositioning of the tube when the carina was not seen on the camera monitor.

RESULTS

During anaesthesia, tiny movements synchronous with heart beats and lung ventilation were observed. Tube movement of 1 cm was detected in eight (26%) patients. In two (7%) patients, the carina was no longer viewed after moving to the lithotomy position and the tube was repositioned. None of the events was associated with changes in oxygen saturation, end-tidal CO(2), or airway pressure.

CONCLUSIONS

We found that the ETView TVT facilitated surveillance of tube position by providing a clear high-quality view of the carina, throughout PCNL with several changes of patient position.

摘要

背景

全身麻醉期间气管导管(TT)移位可能导致危及生命的并发症,而持续直接观察导管位置则可能更安全地进行管理。ETView 气管镜通气导管(TVT)是一种一次性使用的 TT,其尖端集成了摄像头和光源。尖端的视图会连续显示在麻醉师附近的便携式监视器上。本研究旨在测试 ETView TVT 在全身麻醉期间监测 TT 位置的效果。

方法

在这项前瞻性研究中,使用 ETView TVT 对 30 例接受经皮肾镜碎石术(PCNL)的成年患者进行通气,该手术需要三次改变患者体位。在手术过程中,麻醉师通过 ETView TVT 便携式监视器上的隆突视图进行监测。记录导管在 1cm 内的移动情况,以及当相机监视器上未看到隆突时重新定位导管的需要。

结果

在麻醉期间,观察到与心跳和肺通气同步的微小运动。在 8 名(26%)患者中检测到导管移动 1cm。在 2 名(7%)患者中,转为截石位后不再观察到隆突,需要重新定位导管。这些事件均与氧饱和度、呼气末二氧化碳或气道压力的变化无关。

结论

我们发现,ETView TVT 通过提供清晰的高质量隆突视图,便于在 PCNL 期间监测导管位置,即使患者体位发生多次变化也如此。

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