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在接受肺叶切除术的患者中,使用ETView气管导管进行导管定位后的监测,随机试验。

The use of ETView endotracheal tube for surveillance after tube positioning in patients undergoing lobectomy, randomized trial.

作者信息

Liu Hui-Hui, Dong Fang, Liu Jia-Yi, Wei Jian-Qi, Huang Yan-Kui, Wang Yong, Zhou Tao, Ma Wu-Hua

机构信息

Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine.

Graduate School of GuangZhou University of Chinese Medicine.

出版信息

Medicine (Baltimore). 2018 Dec;97(49):e13170. doi: 10.1097/MD.0000000000013170.

DOI:10.1097/MD.0000000000013170
PMID:30544376
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6310589/
Abstract

The ETView tracheoscopic ventilation tube (TVT) is a tracheal tube (TT) incorporating a video camera and a light source in its tip. The view from the tip appears continuously on a portable monitor in the anesthesia area. We evaluated the effectiveness and usefulness of the single/double ETView TVT in monitoring the tracheal tube position during general anesthesia undergoing video-assisted thoracoscopic lobectomy.Eighty-three patients with pulmonary bullae (American Society of Anesthesiologists (ASA) I-III) undergoing lobectomy, with general anaesthesia, were included. Patients were randomly assigned to 3 groups, based on the tube ETView double-lumen tube (VDT), ETView single-lumen tube (VST), or traditional double lumen tube (DT).All 83 patients' intubations were successful to achieve 1-lung ventilation: 74 patients at the first attempt (22/26 in VDT, 26/28 in VST, 26/29 in DT group) and 9 patients at the second attempt. The time to achieve 1-lung ventilation with the VDT was 58.5 ± 21.5 (mean ± SD) seconds, the VST was 38.2 ± 10.1 (mean ± SD) seconds, and the DT group was 195.5 ± 40.3 (mean ± SD) seconds. During operations, the ETView tubes provided continuous airway visualization in all patients; a good view was obtained in 24/25 patients in VDT/VST, moderate in 4/12 patients in VDT/VST, and poor in 1/1 patients in VDT/VST. When the patient left the postanesthesia care unit, all had sore throat and 26/15/25 patients in VDT/VST/DT group had hoarseness. All had good outcomes of the surgical operations.We found the ETView tube to be helpful in the endotracheal intubation and continuous surveillance of tube position in patients with video-assisted thoracoscopic lobectomy. The ETView single lumen endotracheal tube had fewer associated complications and is superior to the 2 double-lumen tubes.

摘要

ETView 气管镜通气导管(TVT)是一种气管导管(TT),其尖端装有摄像头和光源。尖端的视野会持续显示在麻醉区域的便携式监视器上。我们评估了单/双 ETView TVT 在电视辅助胸腔镜肺叶切除术全身麻醉期间监测气管导管位置的有效性和实用性。

纳入了 83 例接受肺叶切除术且全身麻醉的肺大疱患者(美国麻醉医师协会(ASA)分级 I - III 级)。根据导管类型,患者被随机分为 3 组:ETView 双腔导管(VDT)组、ETView 单腔导管(VST)组或传统双腔导管(DT)组。

所有 83 例患者的插管均成功实现单肺通气:74 例患者一次插管成功(VDT 组 22/26 例、VST 组 26/28 例、DT 组 26/29 例),9 例患者二次插管成功。VDT 组实现单肺通气的时间为 58.5±21.5(均值±标准差)秒,VST 组为 38.2±10.1(均值±标准差)秒,DT 组为 195.5±40.3(均值±标准差)秒。手术过程中,ETView 导管在所有患者中均提供了持续的气道视野;VDT/VST 组 24/25 例患者视野良好,4/12 例患者视野中等,1/1 例患者视野较差。患者离开麻醉后监护病房时,均有咽痛,VDT/VST/DT 组分别有 26/15/25 例患者出现声音嘶哑。所有患者手术结局良好。

我们发现 ETView 导管有助于电视辅助胸腔镜肺叶切除术患者的气管插管及导管位置的持续监测。ETView 单腔气管导管相关并发症较少,优于两种双腔导管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42d6/6310589/529dc3a6a0fc/medi-97-e13170-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42d6/6310589/94983ce0b3ec/medi-97-e13170-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42d6/6310589/97ee9f702ecb/medi-97-e13170-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42d6/6310589/529dc3a6a0fc/medi-97-e13170-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42d6/6310589/94983ce0b3ec/medi-97-e13170-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42d6/6310589/97ee9f702ecb/medi-97-e13170-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42d6/6310589/529dc3a6a0fc/medi-97-e13170-g006.jpg

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