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在模拟颈椎创伤中使用King Vision喉镜进行视频喉镜插管:非通道型与通道型一次性刀片的比较

Video Laryngoscopic Intubation Using the King Vision Laryngoscope in a Simulated Cervical Spine Trauma: A Comparison Between Non-Channeled and Channeled Disposable Blades.

作者信息

Votruba Jiri, Brozek Tomas, Blaha Jan, Henlin Tomas, Vymazal Tomas, Donaldson Will, Michalek Pavel

机构信息

First Department of Tuberculosis and Respiratory Care, 1st Medical Faculty of the Charles University and General University Hospital, 128 00 Prague, Czech Republic.

Department of Anaesthesia and Intensive Medicine, 1st Medical Faculty of the Charles University and General University Hospital, 128 00 Prague, Czech Republic.

出版信息

Diagnostics (Basel). 2020 Mar 3;10(3):139. doi: 10.3390/diagnostics10030139.

Abstract

Videolaryngoscopes may reduce cervical spine movement during tracheal intubation in patients with neck trauma. This manikin study aimed to compare the performance of disposable non-channeled and channeled blades of the King Vision™ videolaryngoscope in simulated cervical spine injury. Fifty-eight anesthesiologists in training intubated the TruMan manikin with the neck immobilized using each blade in a randomized order. The primary outcome was the time needed for tracheal intubation, secondary aims included total success rate, the time required for visualization of the larynx, number of attempts, view of the vocal cords, and subjective assessment of both methods. Intubation time with the channeled blade was shorter, with a median time of 13 s (IQR 9-19) . 23 s (14.5-37.5), < 0.001, while times to visualization of the larynx were similar in both groups ( = 0.54). Success rates were similar in both groups, but intubation with the non-channeled blade required more attempts (1.52 . 1.05; < 0.001). The participants scored the intubation features of the channeled blade significantly higher, while visualization features were scored similarly in both groups. Both blades of the King Vision™ videolaryngoscope are reliable intubation devices in a simulated cervical spine injury in a manikin model when inserted by non-experienced operators. The channeled blade allowed faster intubation of the trachea.

摘要

视频喉镜可能会减少颈部创伤患者气管插管过程中颈椎的移动。这项人体模型研究旨在比较King Vision™视频喉镜一次性无通道和有通道叶片在模拟颈椎损伤中的性能。58名正在接受培训的麻醉医生以随机顺序使用每种叶片对颈部固定的TruMan人体模型进行插管。主要结局是气管插管所需时间,次要目标包括总成功率、暴露喉部所需时间、尝试次数、声带视野以及对两种方法的主观评估。使用有通道叶片的插管时间较短,中位时间为13秒(四分位间距9 - 19),而无通道叶片为23秒(14.5 - 37.5),P < 0.001,而两组暴露喉部的时间相似(P = 0.54)。两组成功率相似,但使用无通道叶片插管需要更多尝试次数(1.52对1.05;P < 0.001)。参与者对有通道叶片的插管特征评分显著更高,而两组对视野特征的评分相似。当由非经验丰富的操作者插入时,King Vision™视频喉镜的两种叶片在人体模型模拟颈椎损伤中都是可靠的插管设备。有通道叶片能更快地完成气管插管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9c6/7151076/ad1a368c224d/diagnostics-10-00139-g001.jpg

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