Truszewski Zenon, Czyzewski Lukasz, Smereka Jacek, Krajewski Paweł, Fudalej Marcin, Madziala Marcin, Szarpak Lukasz
Department of Emergency Medicine, Medical University of Warsaw, Poland.
Department of Nephrologic Nursing, Medical University of Warsaw, Warsaw, Poland.
Am J Emerg Med. 2016 Sep;34(9):1835-9. doi: 10.1016/j.ajem.2016.06.054. Epub 2016 Jun 16.
The aim of the trial was to compare the time parameters for intubation with the use of the Macintosh (MAC) laryngoscope and Pentax AWS-S100 videolaryngoscope (AWS; Pentax Corporation, Tokyo, Japan) with and without chest compression (CC) by paramedics during simulated cardiopulmonary resuscitation in a cadaver model.
This was a randomized crossover cadaver trial. Thirty-five paramedics with no experience in videolaryngoscopy participated in the study. They performed intubation in two emergency scenarios: scenario A, normal airway without CC; scenario B, normal airway with continuous CC.
The median time to first ventilation with the use of the AWS and the MAC was similar in scenario A: 25 (IQR, 22-27) seconds vs. 24 (IQR, 22.5-26) seconds (P=.072). A statistically significant difference in TTFV between AWS and MAC was noticed in scenario B (P=.011). In scenario A, the first endotracheal intubation (ETI) attempt success rate was achieved in 97.1% with AWS compared with 94.3% with MAC (P=.43). In scenario B, the success rate after the first ETI attempt with the use of the different intubation methods varied and amounted to 88.6% vs. 77.1% for AWS and MAC, respectively (P=.002).
The Pentax AWS offered a superior glottic view as compared with the MAC laryngoscope, which was associated with a higher intubation rate and a shorter intubation time during an uninterrupted CC scenario. However, in the scenario without CC, the results for AWS and MAC were comparable.
本试验旨在比较在尸体模型模拟心肺复苏过程中，护理人员使用麦金托什（MAC）喉镜和宾得AWS-S100视频喉镜（AWS；日本东京宾得公司）进行气管插管时，有无胸外按压（CC）情况下的时间参数。
这是一项随机交叉尸体试验。35名无视频喉镜操作经验的护理人员参与了研究。他们在两种紧急情况下进行气管插管：情况A，无CC的正常气道；情况B，持续CC的正常气道。
在情况A中，使用AWS和MAC首次通气的中位时间相似：25（四分位间距，22 - 27）秒对24（四分位间距，22.5 - 26）秒（P = 0.072）。在情况B中，AWS和MAC之间的首次通气时间（TTFV）存在统计学显著差异（P = 0.011）。在情况A中，使用AWS首次气管插管（ETI）尝试成功率为97.1%，而使用MAC为94.3%（P = 0.43）。在情况B中，使用不同插管方法首次ETI尝试后的成功率有所不同，AWS和MAC分别为88.6%和77.1%（P = 0.002）。
与MAC喉镜相比，宾得AWS提供了更好的声门视野，这与在不间断CC情况下更高的插管率和更短的插管时间相关。然而，在无CC的情况下，AWS和MAC的结果相当。
