Department of Anesthesiology, Vanderbilt University School of Medicine, 1301 Med Ctr Dr, 4648 TVC, Nashville, TN, 37232, USA,
J Clin Monit Comput. 2013 Oct;27(5):561-5. doi: 10.1007/s10877-013-9464-3. Epub 2013 Apr 13.
Prolonged time during endotracheal tube placement has been associated with poor outcomes, including cardiac arrest and death. For this reason, the accurate measurement of the duration of intubation time is an important metric in studies that evaluate interventions to improve airway outcomes. In the current study we correlated the gaps in routinely measured ventilatory parameters with duration of the intubation procedure to determine if these intervals could be used to accurately calculate the intubation time. Fifty-six random airway management encounters were video recorded along with a continuous video feed of the patient monitor. Intubation event times were measured and correlated with "gap" times of end-tidal carbon dioxide, airway pressure, airway flow, tidal volume, and respiratory rate defined as the disappearance of the parameter at the end of mask ventilation to the reappearance after intubation. Scatter plots were generated for intubation times versus each parameter time gap and correlation coefficients were calculated. Of the 56 recordings 50 of were suitable for analysis. The correlation of the gaps in airway pressure and airway flow correlated best with the duration of intubation (R(2) = 0.88) and were available on all cases. The gap in measured tidal volume of 39 ± 53 s most closely approximated the actual duration of intubation of 38 ± 28 s, (R(2) = 0.85, y = x - 0.87). During intubation, the disappearance gaps in tidal volume, and the airway pressure and flow waveforms highly correlate with the duration of the intubation procedure and may be useful in the evaluation of airway management interventions. However, just as there are limitations to a labor-intensive method of recording airway management timing, there are limitations to using an automated method.
气管插管过程中时间延长与不良结局相关，包括心脏骤停和死亡。因此，准确测量插管时间的持续时间是评估改善气道结局干预措施的研究中的一个重要指标。在本研究中，我们将常规测量的通气参数的间隙与插管过程的持续时间相关联，以确定这些间隔是否可用于准确计算插管时间。56 例随机气道管理事件与患者监护仪的连续视频馈送一起进行视频记录。测量插管事件时间，并将其与呼气末二氧化碳、气道压力、气道流量、潮气量和呼吸频率的“间隙”时间相关联，定义为面罩通气结束时参数的消失到插管后再次出现的时间间隔。生成了插管时间与每个参数时间间隔的散点图，并计算了相关系数。在 56 个记录中，有 50 个适合进行分析。气道压力和气道流量的间隙与插管时间的相关性最好（R(2) = 0.88），并且在所有病例中都可用。测量潮气量的间隙为 39 ± 53 s，最接近实际插管持续时间 38 ± 28 s（R(2) = 0.85，y = x - 0.87）。在插管过程中，潮气量、气道压力和流量波形的消失间隙与插管过程的持续时间高度相关，可能有助于评估气道管理干预措施。然而，就像记录气道管理时间的劳动密集型方法存在局限性一样，使用自动化方法也存在局限性。
