Furyk C, Walsh M L, Kaliaperumal I, Bentley S, Hattingh C
Anaesth Intensive Care. 2017 Nov;45(6):695-699. doi: 10.1177/0310057X1704500608.
The Staged Extubation Set has recently been introduced by Cook Medical for the management of difficult airway patients who potentially require reintubation; however, its reliability for intubation and ease of use is not reported in the literature. The set contains a wire and reintubation catheter with a central lumen for the wire and oxygenation if required. Reintubation is by a two-stage Seldinger-like technique. After induction of general anaesthesia, 23 low-risk elective surgical patients had the Staged Extubation Wire from the Cook set inserted into their trachea under direct laryngoscopy. The intubation was subsequently completed using the rest of the Staged Extubation Set as designed. Difficult intubation was simulated by intentionally decreasing the laryngeal view. Simulated reintubation failed in 8.3% and significant technical difficulty in simulated reintubation was noted in another 17.3% of intubation sequences. The latter represent probable failures in a clinical difficult reintubation setting. The mean time taken to intubate was 109 seconds. Using the Cook Staged Extubation Set may be inferior to using an airway exchange catheter for reintubation.
库克医疗公司最近推出了分期拔管套件，用于处理可能需要再次插管的困难气道患者；然而，其插管的可靠性和易用性在文献中尚无报道。该套件包含一根导丝和再插管导管，导管有一个中央腔，用于容纳导丝并在需要时进行氧合。再插管采用类似Seldinger技术的两阶段方法。在全身麻醉诱导后，23例低风险择期手术患者在直接喉镜检查下将库克套件中的分期拔管导丝插入气管。随后按照设计使用分期拔管套件的其余部分完成插管。通过故意降低喉镜视野来模拟困难插管。模拟再插管失败率为8.3%，另有17.3%的插管序列在模拟再插管时出现明显技术困难。后者在临床困难再插管情况下可能代表失败。插管平均用时109秒。使用库克分期拔管套件进行再插管可能不如使用气道交换导管。
