Kaplan Atilla, Göksu Erkan, Yıldız Gunay, Kılıç Taylan
Department of Emergency Medicine, Akdeniz University School of Medicine, Antalya, Turkey.
Antalya Education and Research Hospital, Antalya, Turkey.
J Emerg Med. 2016 Mar;50(3):e107-14. doi: 10.1016/j.jemermed.2015.06.070. Epub 2015 Dec 22.
Intubation is a fundamental skill in maintaining adequate oxygenation and ventilation of seriously ill patients.
To compare the C-MAC video laryngoscope and Bonfils intubation fiberscope with direct laryngoscopy in simulated easy and difficult airway scenarios.
This was a prospective, randomized-controlled cross-sectional study. Thirty emergency medicine residents attempted to intubate a manikin using four progressively more difficult airway settings (normal airway [scenario 1], cervical spine immobilization [scenario 2], cervical spine immobilization + tongue swelling scenario [scenario 3], and cervical spine immobilization + tongue swelling + limited jaw opening scenario [scenario 4]) with both the C-MAC video laryngoscope and the Bonfils intubation fiberscope and direct laryngoscope.
In the first and the second scenarios, there were no statistically significant differences between the airway devices in terms of the duration of endotracheal intubation, the viewing duration of the glottic opening, and endotracheal tube insertion time. There was no statistically significant difference between the laryngoscopes in terms of the duration of endotracheal intubation and endotracheal tube insertion time in the third scenario. The overall success rates and the viewing duration of the glottic opening were shorter with the C-MAC and Bonfils in scenarios 3 and 4. Furthermore, the duration of intubation was better with Bonfils in scenario 4. The severity of dental trauma was lowest with the Bonfils in all scenarios. The device difficulty score was greatest with the Macintosh blade, except in the normal airway scenario. The most preferred airway device was the C-MAC.
The Bonfils and C-MAC enabled better visualization of the glottic opening when compared with the Macintosh laryngoscope.
气管插管是维持重症患者充分氧合和通气的一项基本技能。
在模拟的简易和困难气道场景中，比较C-MAC视频喉镜、邦菲尔斯插管纤维喉镜与直接喉镜。
这是一项前瞻性、随机对照横断面研究。30名急诊医学住院医师使用C-MAC视频喉镜、邦菲尔斯插管纤维喉镜和直接喉镜，在四种难度逐渐增加的气道设置（正常气道[场景1]、颈椎固定[场景2]、颈椎固定+舌肿胀场景[场景3]、颈椎固定+舌肿胀+张口受限场景[场景4]）下尝试对模拟人进行气管插管。
在第一和第二种场景中，就气管插管持续时间、声门开口观察时间和气管导管插入时间而言，气道设备之间无统计学显著差异。在第三种场景中，就气管插管持续时间和气管导管插入时间而言，喉镜之间无统计学显著差异。在场景3和4中，C-MAC和邦菲尔斯的总体成功率和声门开口观察时间较短。此外，在场景4中，邦菲尔斯的插管持续时间更佳。在所有场景中，邦菲尔斯造成的牙齿创伤严重程度最低。除正常气道场景外，麦金托什喉镜的设备难度评分最高。最受青睐的气道设备是C-MAC。
与麦金托什喉镜相比，邦菲尔斯和C-MAC能更好地观察声门开口。
