Abdelgawad Amro Faez, Shi Qin-Fang, Halawa Mohamed Abo, Wu Zhi-Lin, Wu Zhou-Yang, Chen Xiang-Dong, Yao Shang-Long
Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Anesthesiology, Faculty of Medicine, Benha University, Benha, Egypt.
J Huazhong Univ Sci Technolog Med Sci. 2015 Jun;35(3):432-438. doi: 10.1007/s11596-015-1449-7. Epub 2015 Jun 14.
Tracheal intubation with Macintosh laryngoscope (MAC) might result in severe cardiovascular complications. The results of conducted studies investigating the effects of videolaryngoscopies on hemodynamic response of tracheal intubation are conflicting. We know little about the effects of videolaryngoscopies on cardiac output changes during tracheal intubation. We compared cardiac output (COP) and hemodynamic responses in normal blood pressure (n=60) and hypertensive patients (n=60) among 3 intubation devices: the MAC, the UE videolaryngoscopy ® (UE), and the UE video intubation stylet ® (VS). Cardiac index (CI), stroke volume index (SVI), heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded using LidcoRapid (V2)® preinduction, preintubation, and every minute for the first 5 min after intubation. We assessed oropharyngeal and laryngeal structures injury as well. Intubation time was significantly shorter than MAC groups (P<0.001) only in UE group of normotensive and hypertensive patients. In normotensive patients, there were no significant differences in any of COP variables or hemodynamic variables among the three devices. In hypertensive patients, SBP and DBP in the MAC group were significantly higher (P<0.05 or <0.01) than the UE and VS groups at 1, 2 and 3 min after intubation, but there were no significant differences in CI, SVI and HR among the three devices. There was no significant difference in oropharyngeal and laryngeal structures injury among all groups. It was concluded that both the UE and VS attenuate only the hemodynamic response to intubation as compared with the MAC in hypertensive patients, but not in normotensive patients.
使用麦金托什喉镜（MAC）进行气管插管可能会导致严重的心血管并发症。关于视频喉镜对气管插管血流动力学反应影响的研究结果相互矛盾。我们对视频喉镜在气管插管期间对心输出量变化的影响了解甚少。我们比较了3种插管设备（MAC、UE视频喉镜®（UE）和UE视频插管探条®（VS））在正常血压患者（n = 60）和高血压患者（n = 60）中的心输出量（COP）和血流动力学反应。使用LidcoRapid（V2）®在诱导前、插管前以及插管后前5分钟每分钟记录心脏指数（CI）、每搏量指数（SVI）、心率（HR）、收缩压（SBP）和舒张压（DBP）。我们还评估了口咽和喉部结构损伤情况。仅在正常血压和高血压患者的UE组中，插管时间明显短于MAC组（P<0.001）。在正常血压患者中，三种设备在任何COP变量或血流动力学变量方面均无显著差异。在高血压患者中，MAC组的SBP和DBP在插管后1、2和3分钟时显著高于UE组和VS组（P<0.05或<0.01），但三种设备在CI、SVI和HR方面无显著差异。所有组在口咽和喉部结构损伤方面无显著差异。得出的结论是，与MAC相比，UE和VS仅在高血压患者中减弱了插管的血流动力学反应，而在正常血压患者中则没有。
