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困难小儿气道——两岁以下儿童间接喉镜检查新设备综述

The difficult pediatric airway--a review of new devices for indirect laryngoscopy in children younger than two years of age.

作者信息

Holm-Knudsen Rolf

机构信息

Department of Anaesthesia, Copenhagen University Hospital, Copenhagen O, Denmark.

出版信息

Paediatr Anaesth. 2011 Feb;21(2):98-103. doi: 10.1111/j.1460-9592.2010.03487.x. Epub 2010 Dec 15.

DOI:10.1111/j.1460-9592.2010.03487.x
PMID:21159025
Abstract

During the last decade, several new look-around-corner or video airway devices have proven useful in clinical adult practice. Only four of them are currently available in sizes that may be used in children younger than 2 years of age: the AIRTRAQ® Disposable Optical Laryngoscope (Prodol Meditec, Vizcaya, Spain), the GlideScope® Video Laryngoscope (Verathon, Bothell, WA, USA), the Storz DCI® Video Laryngoscope (Karl Storz, Tuttlingen, Germany), and the Truview PCD™ Infant (Truphatek, Netanya, Israel). Here, we review the literature and describe the clinical use of each device in this age-group. The four new laryngoscopes are generally effective and may solve many of the problems with difficult intubations in children younger than 2 years of age. The size of the device and the mouth opening it requires determines its usefulness in the smallest infants. Training will be necessary in implementing and deciding when to use the new airway devices, although one of the big challenges of the future will be to maintain the teaching and training of fiber-optic-guided intubations, which remain the gold standard in difficult endotracheal intubations.

摘要

在过去十年中,几种新型的可视或视频气道装置已被证明在成人临床实践中很有用。目前仅有其中四种型号可供2岁以下儿童使用:AIRTRAQ®一次性光学喉镜(Prodol Meditec,西班牙比斯开)、GlideScope®视频喉镜(Verathon,美国华盛顿州博塞尔)、史托斯DCI®视频喉镜(卡尔·史托斯,德国图特林根)以及Truview PCD™婴儿型喉镜(Truphatek,以色列内坦亚)。在此,我们回顾相关文献,并描述每种装置在该年龄组中的临床应用。这四种新型喉镜总体上是有效的,并且可能解决2岁以下儿童困难插管的许多问题。装置的尺寸及其所需的开口大小决定了其在最小婴儿中的适用性。在使用和决定何时使用新型气道装置时需要进行培训,尽管未来的一大挑战将是维持纤维支气管镜引导插管的教学与培训,而纤维支气管镜引导插管仍是困难气管插管的金标准。

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