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Airtraq®光学喉镜在高危心脏手术患者常规气管插管中的应用。

The use of the Airtraq® optical laryngoscope for routine tracheal intubation in high-risk cardio-surgical patients.

作者信息

Schälte Gereon, Scheid Ulrike, Rex Steffen, Coburn Mark, Fiedler Britta, Rossaint Rolf, Zoremba Norbert

机构信息

Department of Anesthesiology, University Hospital Aachen, Aachen, Germany.

出版信息

BMC Res Notes. 2011 Oct 19;4:425. doi: 10.1186/1756-0500-4-425.

Abstract

BACKGROUND

The Airtraq® optical laryngoscope (Prodol Ltd., Vizcaya, Spain) is a novel disposable device facilitating tracheal intubation in routine and difficult airway patients. No data investigating routine tracheal intubation using the Airtaq® in patients at a high cardiac risk are available at present. Purpose of this study was to investigate the feasibility and hemodynamic implications of tracheal intubation with the Aitraq® optical laryngoscope, in high-risk cardio-surgical patients.

METHODS

123 consecutive ASA III patients undergoing elective coronary artery bypass grafting were routinely intubated with the Airtraq® laryngoscope. Induction of anesthesia was standardized according to our institutional protocol. All tracheal intubations were performed by six anesthetists trained in the use of the Airtraq® prior.

RESULTS

Overall success rate was 100% (n = 123). All but five patients trachea could be intubated in the first attempt (95,9%). 5 patients were intubated in a 2nd (n = 4) or 3rd (n = 1) attempt. Mean intubation time was 24.3 s (range 16-128 s). Heart rate, arterial blood pressure and SpO2 were not significantly altered. Minor complications were observed in 6 patients (4,8%), i.e. two lesions of the lips and four minor superficial mucosal bleedings. Intubation duration (p = 0.62) and number of attempts (p = 0.26) were independent from BMI and Mallampati score.

CONCLUSION

Tracheal intubation with the Airtraq® optical laryngoscope was feasible, save and easy to perform in high-risk patients undergoing cardiac surgery. In all patients, a sufficient view on the vocal cords could be obtained, independent from BMI and preoperative Mallampati score.

TRIAL REGISTRATION

DRKS 00003230.

摘要

背景

Airtraq®可视喉镜(Prodol有限公司,西班牙比斯开省)是一种新型一次性器械,可辅助常规气道和困难气道患者进行气管插管。目前尚无关于在心脏高危患者中使用Airtraq®进行常规气管插管的数据。本研究旨在探讨在高危心脏手术患者中使用Aitraq®可视喉镜进行气管插管的可行性及对血流动力学的影响。

方法

123例连续接受择期冠状动脉搭桥术的ASA III级患者,使用Airtraq®喉镜进行常规插管。麻醉诱导按照我们机构的方案进行标准化。所有气管插管均由6名之前接受过Airtraq®使用培训的麻醉医生完成。

结果

总体成功率为100%(n = 123)。除5例患者外,其余所有患者均在首次尝试时成功插管(95.9%)。5例患者在第二次(n = 4)或第三次(n = 1)尝试时成功插管。平均插管时间为24.3秒(范围16 - 128秒)。心率、动脉血压和SpO2无显著变化。6例患者(4.8%)出现轻微并发症,即2例唇部损伤和4例轻微浅表黏膜出血。插管持续时间(p = 0.62)和尝试次数(p = 0.26)与BMI和马兰帕蒂评分无关。

结论

在接受心脏手术的高危患者中,使用Airtraq®可视喉镜进行气管插管是可行、安全且易于操作的。在所有患者中,均可获得足够的声门视野,与BMI和术前马兰帕蒂评分无关。

试验注册

DRKS 00003230。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c971/3213174/071b0bad8ef9/1756-0500-4-425-1.jpg

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