Saraçoğlu Ayten, Bezen Olgaç, Şengül Türker, Uğur Egin Hüsnü, Şener Sibel, Yüzer Fisun
Department of Anaesthesiology, Bilim University Faculty of Medicine, İstanbul, Turkey.
Health Services Vocational High School, Bilim University, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2015 Aug;43(4):263-8. doi: 10.5152/TJAR.2015.52207. Epub 2015 Mar 3.
Interruption of chest compressions should be minimized because of its negative effects on survival. This randomized, controlled, cross-over study aimed to analyze the effectiveness of Macintosh, Miller, McCoy and McGrath laryngoscopes during with or without chest compressions in the scope of a simulated cardiopulmonary resuscitation scenario.
The time required for successful tracheal intubation, number of attempts, dental trauma severity and the need for optimization manoeuvres were recorded during cardiopulmonary resuscitation with and without chest compressions. The experience with computer games during the last 10 years were asked to the participants and recorded.
McCoy laryngoscope yielded the shortest time for successful tracheal intubation both in the presence of and without chest compressions. During the use of McCoy laryngoscopes, fewer tracheal intubation attempts, lower incidence of dental trauma and lower visual analogue scale scores on the ease of intubation were recorded. Participants who are experienced computer game players using Macintosh, McCoy and McGrath achieved successful tracheal intubation in a significantly shorter time during resuscitation without chest compressions. Dental trauma incidence and number of tracheal intubation attempts did not show any significant difference between the four laryngoscopes being related to the rate of playing computer games.
McGrath video laryngoscopes do not appear to have advantages over direct laryngoscopes for securing a smooth and successful tracheal intubation during rhythmic chest compressions. We believe that as McCoy laryngoscope provided tracheal intubation in a shorter time and with fewer attempts, this laryngoscope may increase the success rate of resuscitation.
由于胸外按压对生存率有负面影响，应尽量减少胸外按压的中断。这项随机、对照、交叉研究旨在分析在模拟心肺复苏场景中，有或无胸外按压时，麦金托什喉镜、米勒喉镜、麦考伊喉镜和麦格拉斯喉镜的有效性。
记录有胸外按压和无胸外按压的心肺复苏过程中成功气管插管所需时间、尝试次数、牙齿创伤严重程度以及优化操作的必要性。询问参与者过去10年玩电脑游戏的经历并记录。
无论有无胸外按压，麦考伊喉镜成功气管插管所需时间最短。使用麦考伊喉镜时，气管插管尝试次数更少，牙齿创伤发生率更低，插管 ease 的视觉模拟评分更低。有电脑游戏经验的参与者在使用麦金托什喉镜、麦考伊喉镜和麦格拉斯喉镜进行无胸外按压的复苏时，成功气管插管的时间明显更短。与玩电脑游戏的频率相关，四种喉镜的牙齿创伤发生率和气管插管尝试次数均无显著差异。
在有节律的胸外按压期间，麦格拉斯视频喉镜在确保顺利成功气管插管方面似乎并不比直接喉镜有优势。我们认为，由于麦考伊喉镜能在更短时间内且以更少的尝试次数完成气管插管，这种喉镜可能会提高复苏成功率。
