Cairns Hospital, Cairns, Qld, Australia.
The Townsville Hospital, Douglas, Qld, Australia.
Anaesthesia. 2018 May;73(5):587-593. doi: 10.1111/anae.14244. Epub 2018 Mar 25.
The Cook staged extubation set (Cook Medical) has been developed to facilitate management of the difficult airway. A guidewire inserted before tracheal extubation provides access to the subglottic airway should re-intubation be required. This prospective cohort study examines patients' tolerance of the guidewire and its impact on clinical status around tracheal extubation in the intensive care unit. Vital signs, incidence of symptoms and patient tolerance of the wire were recorded. Twenty-three patients were enrolled and 17 (73%) tolerated the wire for 4 h. Nasendoscopy was performed in 11 of these patients and revealed one wire was in the oesophagus. The most common symptom was a mild intermittent cough in 13 patients. There was no impact of the guidewire on nursing care in 16 patients, tolerable impact in five and severe impact necessitating removal of the wire in one patient.
库克（Cook Medical）公司研发的库克（Cook）导丝式气管拔管套件旨在便于处理困难气道。在气管拔管前插入导丝，以备再次插管提供经声门下气道的入路。这项前瞻性队列研究观察了患者对导丝的耐受情况及其对 ICU 中气管拔管前后临床状况的影响。记录生命体征、症状发生率和患者对导丝的耐受情况。共纳入 23 例患者，17 例（73%）耐受导丝 4 小时。11 例患者进行了鼻内镜检查，发现 1 例导丝位于食管内。最常见的症状是 13 例患者出现轻度间歇性咳嗽。16 例患者导丝对护理无影响，5 例患者影响可耐受，1 例患者影响严重需取出导丝。
