Moritz Andreas, Prottengeier Johannes, Schmidt Joachim
Department of Anesthesiology, University Hospital Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany.
Department of Anesthesiology, University Hospital Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany.
Am J Emerg Med. 2017 Nov;35(11):1639-1644. doi: 10.1016/j.ajem.2017.05.008. Epub 2017 May 8.
The purpose of this study was to compare the effectiveness of a Xenon halogen with a light-emitting diode (LED) laryngoscope light handle in a difficult airway scenario, as well as in an inhalation injury airway scenario that combines a difficult airway and a limited view.
We recruited forty-two anesthetists into a randomized crossover trial. Each performed tracheal intubation (TI) with a Xenon halogen and a LED light handle in the two manikin scenarios. The primary endpoint was the "time to intubate". Other endpoints were the "time to vocal cords", the "time to ventilate", the rate of successful intubation, the number of intubation attempts, the Cormack-Lehane score, the number of optimization maneuvers, the number of audible dental click sounds indicating dental damage and subjective impressions.
In the difficult airway scenario, no significant differences in the recorded intubation times were observed. In the inhalation injury airway scenario, the intubation times were significantly shorter using the LED light handle. Regarding the subjective values, the LED illuminant enabled a significant better view and illumination of the oropharyngeal space and the vocal cords, in both manikin scenarios.
The LED laryngoscope light handle did not affect the recorded intubation times in the simulated difficult airway scenario, but provided significant advantages in the inhalation injury airway scenario that combines a difficult airway with a limited view caused by a sooted pharynx. We therefore hypothesize, that the LED illuminant might be beneficial in the airway management of burn patients with severe inhalation injury.
本研究旨在比较氙气卤素灯与发光二极管（LED）喉镜灯柄在困难气道情况下以及在合并困难气道和视野受限的吸入性损伤气道情况下的有效性。
我们招募了42名麻醉医生参与一项随机交叉试验。每位医生在两种人体模型场景中分别使用氙气卤素灯和LED灯柄进行气管插管（TI）。主要终点是“插管时间”。其他终点包括“看到声带的时间”、“通气时间”、插管成功率、插管尝试次数、Cormack-Lehane评分、优化操作次数、表明牙齿损伤的可听牙齿咔哒声次数以及主观印象。
在困难气道情况下，未观察到记录的插管时间有显著差异。在吸入性损伤气道情况下，使用LED灯柄时插管时间显著缩短。关于主观评价，在两种人体模型场景中，LED光源均能显著改善对口咽腔和声带的视野及照明。
在模拟困难气道情况下，LED喉镜灯柄不影响记录的插管时间，但在合并困难气道和因咽部有烟灰导致视野受限的吸入性损伤气道情况下具有显著优势。因此，我们推测，LED光源可能对重度吸入性损伤烧伤患者的气道管理有益。
