Department of Emergency Medicine Geisinger Health System, Danville, Pennsylvania, USA
Prehosp Emerg Care. 2011 Jan-Mar;15(1):30-3. doi: 10.3109/10903127.2010.519821. Epub 2010 Nov 10.
To compare the success and ease of bougie-assisted intubation (BAI) with those of traditional endotracheal intubation (ETI) in a simulated difficult airway (20.4 seconds for BAI vs. 16.7 seconds for ETI, p = 0.102).
This was a prospective, randomized, crossover, single-blind study comparing BAI with ETI in a simulated difficult airway. The 35 participants included paramedics, flight nurses, and emergency medicine resident physicians. Participants were already experienced in ETI and received a brief demonstration of BAI. A simulated difficult airway was created using a Laerdal adult intubation manikin. Cervical motion was mechanically limited to provide a grade III Cormack and Lehane glottic view. Participants performed ETI and BAI in randomized order. Successful placement in the trachea and time to successful placement were recorded for both techniques by each participant. After intubating the manikin with both techniques, each participant was asked to complete a Likert-style survey assessing ease of each technique.
Of the 35 participants, 27 were successful with both techniques and two failed with both techniques. The remaining six participants all failed at ETI but were able to intubate using BAI. There was significantly greater success in intubating the simulated difficult airway with BAI than with ETI (94% vs. 77%, p = 0.0313). The order of techniques attempted did not influence this conclusion. There was no difference in average time to successful intubation (20.4 seconds for BAI vs. 16.7 seconds for ETI, p = 0.102). Thirty-two (91.4%) of the participants completed the survey regarding ease of performing each technique. Forty-one percent rated the ease of intubation as the same for the two methods, 50% rated BAI as easier, and 9% rated ETI as easier (p = 0.0006).
In a simulated difficult airway, BAI has a higher success rate than traditional ETI without increasing the time to successful intubation. Intubators perceive BAI as being easier to perform than traditional ETI in this simulated difficult airway scenario.
比较球囊辅助插管（BAI）与传统气管内插管（ETI）在模拟困难气道中的成功率和难易程度（BAI 为 20.4 秒，ETI 为 16.7 秒，p=0.102）。
这是一项前瞻性、随机、交叉、单盲研究，比较了模拟困难气道中 BAI 与 ETI 的效果。35 名参与者包括护理人员、飞行护士和急诊医学住院医师。参与者已经熟练掌握了 ETI，并接受了 BAI 的简短演示。使用 Laerdal 成人插管模型创建了一个模拟困难气道。颈部运动通过机械限制来提供 Cormack 和 Lehane 分级 III 级声门视图。参与者以随机顺序进行 ETI 和 BAI。每位参与者记录两种技术在气管内成功放置的时间和成功率。在使用两种技术插入模型后，每位参与者都要完成一项李克特量表式调查，评估两种技术的易用性。
35 名参与者中，27 名成功完成了两种技术，2 名参与者在两种技术下均未成功。其余 6 名参与者均在 ETI 失败，但能够使用 BAI 插管。使用 BAI 插管时，模拟困难气道插管的成功率显著高于 ETI（94% vs. 77%，p=0.0313）。尝试技术的顺序并没有影响这一结论。两种技术的平均插管时间无显著差异（BAI 为 20.4 秒，ETI 为 16.7 秒，p=0.102）。32 名（91.4%）参与者完成了关于两种技术易用性的调查。41%的参与者认为两种方法的插管难易程度相同，50%的参与者认为 BAI 更容易，9%的参与者认为 ETI 更容易（p=0.0006）。
在模拟困难气道中，BAI 的成功率高于传统 ETI，而不增加成功插管的时间。在这种模拟困难气道情况下，插管者认为 BAI 比传统 ETI 更容易操作。
