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经口与经环甲膜穿刺气管切开术在活猪模型上的随机比较

A Randomized Comparison of Bougie-Assisted and TracheoQuick Plus Cricothyrotomies on a Live Porcine Model.

机构信息

Department of Anesthesia and Intensive Medicine, First Medical Faculty, Charles University and University Military Hospital, U Vojenske Nemocnice 1200, 169 02 Prague, Czech Republic.

Department of Anesthesia and Intensive Medicine, First Medical Faculty, Charles University and General University Hospital, U Nemocnice 2, 128 08 Prague, Czech Republic.

出版信息

Biomed Res Int. 2017;2017:4215159. doi: 10.1155/2017/4215159. Epub 2017 Dec 19.

DOI:10.1155/2017/4215159
PMID:29359151
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5749220/
Abstract

OBJECTIVES

Cricothyrotomy is a rescue procedure in "cannot intubate, cannot oxygenate" scenarios where other methods of nonsurgical airway management have failed. We compared 2 cuffed cricothyrotomy sets, bougie-assisted cricothyrotomy (BACT) and novel percutaneous TracheoQuick Plus, on a live porcine model in a simulated periarrest situation.

METHODS

Thirty-four anesthetized minipigs were randomly allocated into two groups: BACT technique ( = 17) and TracheoQuick Plus ( = 17). The primary outcome was duration of cricothyrotomy while secondary outcomes were total success rate, number of attempts, location of incision, changes in heart rate, oxygen saturation, and the incidence of complications.

RESULTS

BACT was significantly faster than TracheoQuick Plus cricothyrotomy, with a median time of 69 sec (IQR 56-85) versus 178 sec (IQR 152-272). The total success rate was without difference. 94% of BACT was performed successfully on the first attempt, while in the TracheoQuick Plus group, it was only 18% ( < 0.001). Trauma to the posterior tracheal wall was observed once in the BACT group and 5 times in the TracheoQuick Plus group. Oxygen saturation was significantly higher in the BACT group both during and after the procedure.

CONCLUSIONS

BACT is superior to TracheoQuick Plus cricothyrotomy on a live animal model.

摘要

目的

环甲膜切开术是一种在其他非手术气道管理方法失败的“无法插管、无法给氧”情况下的抢救程序。我们在模拟心跳骤停的情况下，使用活体猪模型比较了两种带囊环甲膜切开套件，即引导管辅助环甲膜切开术（BACT）和新型经皮 TracheoQuick Plus，进行了比较。

方法

34 只麻醉小型猪被随机分配到两组：BACT 技术组（=17）和 TracheoQuick Plus 组（=17）。主要结局是环甲膜切开术的时间，次要结局是总成功率、尝试次数、切口位置、心率、氧饱和度的变化以及并发症的发生率。

结果

BACT 明显快于 TracheoQuick Plus 环甲膜切开术，中位时间为 69 秒（IQR 56-85）与 178 秒（IQR 152-272）。总成功率无差异。BACT 组 94%的病例在第一次尝试时成功，而 TracheoQuick Plus 组只有 18%（<0.001）。BACT 组仅观察到一次后气管壁创伤，而 TracheoQuick Plus 组则有 5 次。BACT 组在手术过程中和手术后的氧饱和度均显著更高。

结论

在活体动物模型中，BACT 优于 TracheoQuick Plus 环甲膜切开术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/48eb1d9107f2/BMRI2017-4215159.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/b5a6aab27fb2/BMRI2017-4215159.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/4949b753035e/BMRI2017-4215159.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/a30a4e89faa1/BMRI2017-4215159.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/5f2a468cfe80/BMRI2017-4215159.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/48eb1d9107f2/BMRI2017-4215159.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/b5a6aab27fb2/BMRI2017-4215159.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/4949b753035e/BMRI2017-4215159.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/a30a4e89faa1/BMRI2017-4215159.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/5f2a468cfe80/BMRI2017-4215159.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034d/5749220/48eb1d9107f2/BMRI2017-4215159.005.jpg

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