Peng Jun, Ye Jianhong, Zhao Yifan, Liang Jianjun, Huang Hailiang, Wei Huafeng, Peng Shuling
Department of Anesthesiology, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
J Emerg Med. 2012 Aug;43(2):382-90. doi: 10.1016/j.jemermed.2011.06.145. Epub 2012 Mar 8.
Supraglottic jet ventilation (SJV) via the "jet endotracheal tube" (JET) designed by Wei (WEI JET; Wei Medical LLC, Cherry Hill, NJ) provides adequate oxygenation and ventilation during direct laryngoscopy and tracheal intubation in animals. It has facilitated intubation in apneic pigs with a simulated difficult airway.
To report on the first clinical study to examine the efficacy of using SJV via the WEI JET, in combination with end-tidal CO(2) pressure (PetCO(2)) monitoring during SJV, in maintaining oxygenation during direct laryngoscopy, and in facilitating placement of the WEI JET, and comparing it to the standard intubation technique using a conventional endotracheal tube. The relative safety of using SJV via the WEI JET in airway management was also addressed to provide the foundation for a larger-scale clinical study using the WEI JET, to be carried out in the future.
Patients in the control group were intubated with a conventional endotracheal tube, and patients in the experimental group were intubated with a WEI JET. The effectiveness of SJV through a WEI JET in maintaining proper oxygenation, and the use of PetCO(2) monitoring to facilitate intubation, were studied and compared to the control group. Complications such as sore throat, laryngospasm, and barotrauma were recorded during the study and 24 h after extubation.
In the WEI JET group, pulse oxygen saturation (SpO(2)) was 100% in all patients during intubation. No serious complications were detected, and the incidence of minor complications was comparable to the control group. Under PetCO(2) guidance, 100% of patients in the WEI JET group were intubated on the first attempt, compared to 30% of Grade III view patients in the control group, who required two attempts.
Using the WEI JET with SJV provides adequate oxygenation during tracheal intubation in apneic patients for a prolonged period of time, with no difference in complications compared to the standard intubation technique. PetCO(2) monitoring facilitated intubation in patients with a Grade III glottis view.
通过Wei设计的“喷射气管导管”（JET；Wei Medical LLC，新泽西州樱桃山）进行声门上喷射通气（SJV），在动物直接喉镜检查和气管插管过程中可提供充足的氧合和通气。它有助于模拟困难气道的呼吸暂停猪的插管操作。
报告第一项临床研究，该研究旨在探讨通过WEI JET进行SJV，并结合SJV期间的呼气末二氧化碳分压（PetCO₂）监测，在直接喉镜检查期间维持氧合、促进WEI JET放置，并将其与使用传统气管导管的标准插管技术进行比较。还探讨了通过WEI JET进行SJV在气道管理中的相对安全性，为未来开展的使用WEI JET的大规模临床研究奠定基础。
对照组患者使用传统气管导管插管，实验组患者使用WEI JET插管。研究了通过WEI JET进行SJV在维持适当氧合方面的有效性，以及使用PetCO₂监测促进插管的情况，并与对照组进行比较。在研究期间和拔管后24小时记录诸如咽痛、喉痉挛和气压伤等并发症。
在WEI JET组中，所有患者在插管期间脉搏血氧饱和度（SpO₂）均为100%。未检测到严重并发症，轻微并发症的发生率与对照组相当。在PetCO₂引导下，WEI JET组100%的患者首次尝试即成功插管，而对照组III级视野患者中30%需要两次尝试。
在呼吸暂停患者气管插管期间，使用带有SJV的WEI JET可长时间提供充足的氧合，与标准插管技术相比并发症无差异。PetCO₂监测有助于声门视野为III级的患者插管。
