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一项关于使用 I-View 和 MacGrath Mac 可视喉镜对超肥胖患者行声门可视分级和喉镜检查时血流动力学反应的随机对照研究。

A randomized controlled study on the visual grading of the glottis and the hemodynamics response to laryngoscopy when using I-View and MacGrath Mac videolaryngoscopes in super obese patients.

机构信息

Department of Anaesthesiology and Intensive Therapy, Medical University of Lodz, Ul. Kopcinskiego 22, 90-153, Lodz, Poland.

出版信息

J Clin Monit Comput. 2021 Apr;35(2):279-283. doi: 10.1007/s10877-020-00503-0. Epub 2020 Apr 2.

Abstract

BACKGROUND

Videolaryngoscopes improve visualization of glottic in morbidly obese patients. Super-obesity is one of the risk factors influencing probability of difficult mask ventilation and difficult intubation. Super-obese (BMI > 50 kg/m) patients should be intubated either with fiberscope awake intubation or with video laryngoscopes.

METHODS

In prospective observational study we decided to compare glottis view during intubation using I-view and McGrath Mac videolaryngoscopes in super obese patients. Patients were randomly allocated into group M (McGrath Mac) or group I (I-View). Obtained view was analyzed regarding POGO (Percentage Of Glottis Opening) scale and the necessity to use of additional aid like intubation stylet was recorded. Hemodynamic response to videolaryngoscopy was assessed.

RESULTS

As results POGO score was better in group M when compared to group I: 81.66 ± 22.8% vs 96.66 ± 7.24% (p = 0.0132) in I and V groups respectively. The use of intubation stylet was similar in both groups. The hemodynamic response to videolaryngoscopy was similar between groups.

CONCLUSION

The POGO score was better for McGrath Mac than for I-view videolaryngoscope, however, both devices allowed for safe and effective intubation in super-obese patients. The hemodynamic response to videolaryngoscopy was similar between devices.

摘要

背景

可视喉镜可改善病态肥胖患者的声门显露。超级肥胖是影响面罩通气困难和插管困难概率的危险因素之一。超级肥胖(BMI>50kg/m )患者应通过纤维喉镜清醒插管或使用视频喉镜进行插管。

方法

在前瞻性观察研究中,我们决定比较超级肥胖患者使用 I-view 和 McGrath Mac 视频喉镜插管时的声门显露情况。患者被随机分配到 McGrath Mac 组(M 组)或 I-view 组(I 组)。根据 POGO(声门显露百分比)评分分析获得的视野,并记录是否需要使用插管导丝等额外辅助工具。评估视频喉镜检查的血流动力学反应。

结果

M 组的 POGO 评分明显优于 I 组:I 组和 V 组分别为 81.66±22.8%和 96.66±7.24%(p=0.0132)。两组使用插管导丝的情况相似。两组的血流动力学反应相似。

结论

与 I-view 视频喉镜相比,McGrath Mac 的 POGO 评分更好,但两种设备均能在超级肥胖患者中实现安全有效的插管。两种设备的视频喉镜血流动力学反应相似。

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