由经验丰富的护理人员在不同气道情况下使用直接喉镜和视频喉镜的比较：一项随机交叉模拟人体研究。
Comparison of Direct and Video Laryngoscopes during Different Airway Scenarios Performed by Experienced Paramedics: A Randomized Cross-Over Manikin Study.
机构信息
Cleveland Clinic, Departments of General Anesthesiology and Outcomes Research, Anesthesiology Institute, Cleveland, OH, USA.
Lazarski University, Medical Simulation Center, Swieradowska 43, Warsaw, Poland.
出版信息
Biomed Res Int. 2020 Feb 18;2020:5382739. doi: 10.1155/2020/5382739. eCollection 2020.
UNLABELLED
. Airway management plays an essential role in anaesthesia practice, during both elective and urgent surgery procedures and emergency medicine.
AIM
The aim of the study was to compare Macintosh laryngoscope (MAC), McGrath, and TruView PCD in 5 separate airway management scenarios.
METHODS
This prospective cross-over simulation study involved 93 paramedics. All paramedics performed intubation using direct laryngoscope (MAC), McGrath, and TruView PCD video laryngoscopes. The study was performed in 5 different scenarios: (A) normal airway, (B) tongue oedema, (C) pharyngeal obstruction, (D) cervical collar stabilization with tongue oedema, and (E) cervical collar stabilization with pharyngeal obstruction.
RESULTS
In scenario A, the success rate was 99% with MAC, 100% with McGrath, and 94% with PCD. Intubation time was 17 s (IQR: 16-21) for MAC, 18 s (IQR: 16-21) for McGrath, and 27 s (IQR: 23-34) for PCD. In scenario B, the success rate was 61% with MAC, 97% with McGrath, and 97% with PCD ( < 0.001). Intubation time was 44 s (IQR: 24-46) for MAC, 22 s (IQR: 20-27) for McGrath, and 39 s (IQR: 30-57) for PCD. In scenario C, the success rate with MAC was 74%, 97% with McGrath, and 72% with PCD ( < 0.001). Intubation time was 44 s (IQR: 24-46) for MAC, 22 s (IQR: 20-27) for McGrath, and 39 s (IQR: 30-57) for PCD. In scenario C, the success rate with MAC was 74%, 97% with McGrath, and 72% with PCD ( < 0.001). Intubation time was 44 s (IQR: 24-46) for MAC, 22 s (IQR: 20-27) for McGrath, and 39 s (IQR: 30-57) for PCD. In scenario C, the success rate with MAC was 74%, 97% with McGrath, and 72% with PCD ( < 0.001). Intubation time was 44 s (IQR: 24-46) for MAC, 22 s (IQR: 20-27) for McGrath, and 39 s (IQR: 30-57) for PCD. In scenario C, the success rate with MAC was 74%, 97% with McGrath, and 72% with PCD (.
CONCLUSIONS
The McGrath video laryngoscope proved better than Truview PCD and direct intubation with Macintosh laryngoscope in terms of success rate, duration of first intubation attempt, number of intubation attempts, Cormack-Lehane grade, percentage of glottis opening (POGO score), number of optimization manoeuvres, severity of dental compression, and ease of use.
目的
本研究旨在比较 Macintosh 喉镜（MAC）、McGrath 和 TruView PCD 在 5 种不同的气道管理场景中的应用。
方法
这是一项前瞻性交叉模拟研究，涉及 93 名护理人员。所有护理人员均使用直接喉镜（MAC）、McGrath 和 TruView PCD 视频喉镜进行插管。研究共进行了 5 种不同的场景：（A）正常气道；（B）舌肿胀；（C）咽阻塞；（D）伴有舌肿胀的颈托稳定；（E）伴有咽阻塞的颈托稳定。
结果
在场景 A 中，MAC 的成功率为 99%，McGrath 为 100%，PCD 为 94%。插管时间为 MAC 17s（IQR：16-21），McGrath 18s（IQR：16-21），PCD 27s（IQR：23-34）。在场景 B 中，MAC 的成功率为 61%，McGrath 为 97%，PCD 为 97%（<0.001）。插管时间为 MAC 44s（IQR：24-46），McGrath 22s（IQR：20-27），PCD 39s（IQR：30-57）。在场景 C 中，MAC 的成功率为 74%，McGrath 为 97%，PCD 为 72%（<0.001）。插管时间为 MAC 44s（IQR：24-46），McGrath 22s（IQR：20-27），PCD 39s（IQR：30-57）。在场景 C 中，MAC 的成功率为 74%，McGrath 为 97%，PCD 为 72%（<0.001）。插管时间为 MAC 44s（IQR：24-46），McGrath 22s（IQR：20-27），PCD 39s（IQR：30-57）。在场景 C 中，MAC 的成功率为 74%，McGrath 为 97%，PCD 为 72%（<0.001）。插管时间为 MAC 44s（IQR：24-46），McGrath 22s（IQR：20-27），PCD 39s（IQR：30-57）。在场景 C 中，MAC 的成功率为 74%，McGrath 为 97%，PCD 为 72%（<0.001）。插管时间为 MAC 44s（IQR：24-46），McGrath 22s（IQR：20-27），PCD 39s（IQR：30-57）。
结论
在成功率、首次插管尝试时间、插管尝试次数、Cormack-Lehane 分级、声门显露评分（POGO 评分）、优化操作次数、牙齿受压严重程度和易用性方面，McGrath 视频喉镜均优于 Truview PCD 和直接用 Macintosh 喉镜插管。
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