在全身个人防护装备下使用 VieScope 与视频喉镜进行插管 - 一项随机对照模拟试验。
Intubation using VieScope vs. Video laryngoscopy in full personal protective equipment - a randomized, controlled simulation trial.
机构信息
Faculty of Medicine, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
出版信息
BMC Anesthesiol. 2021 Nov 22;21(1):288. doi: 10.1186/s12871-021-01502-7.
BACKGROUND
VieScope is a new type of laryngoscope, with a straight, transparent and illuminated blade, allowing for direct line of sight towards the larynx. In addition, VieScope is disposed of after single patient use, which can avoid cross-contaminations of contagious material. This has gained importance especially when treating patients with highly contagious infectious diseases, such as during the SARS-CoV2 pandemic. In this context, VieScope has not been evaluated yet in a clinical study.
MATERIAL AND METHODS
This study compared intubation with VieScope to video-laryngoscopy (GlideScope) in normal and difficult airway in a standardized airway manikin in a randomized controlled simulation trial. Thirty-five medical specialists were asked to perform endotracheal intubation in full personal protective equipment (PPE). Primary endpoint was correct tube position. First-pass rate (i.e., success rate at the first attempt), time until intubation and time until first correct ventilation were registered as secondary endpoints.
RESULTS
For correct tracheal tube placement, there was no significant difference between VieScope and GlideScope in normal and difficult airway conditions. VieScope had over 91% fist-pass success rate in normal airway setting. VieScope had a comparable success rate to GlideScope in difficult airway, but had a significantly longer time until intubation and time until ventilation.
CONCLUSION
VieScope and GlideScope had high success rates in normal as well as in difficult airway. There was no unrecognized esophageal intubation in either group. Overall time for intubation was longer in the VieScope group, though in an acceptable range given in literature. Results from this simulation study suggest that VieScope may be an acceptable alternative for tracheal intubation in full PPE.
TRIAL REGISTRATION
The study was registered at the German Clinical Trials Register www.drks.de (Registration date: 09/11/2020; TrialID: DRKS00023406 ).
背景
VieScope 是一种新型喉镜，其直形、透明和带光的叶片可直视喉部。此外，VieScope 在单次使用后即被丢弃，可避免传染性材料的交叉污染。这在治疗 SARS-CoV2 大流行等具有高度传染性传染病患者时尤为重要。在这种情况下，VieScope 尚未在临床研究中进行评估。
材料和方法
本研究在标准化气道模型中，使用随机对照模拟试验比较了 VieScope 与视频喉镜（GlideScope）在正常和困难气道中的插管情况。35 名医学专家在全身个人防护装备（PPE）下进行气管插管。主要终点是正确的管腔位置。首次通过率（即首次尝试的成功率）、插管时间和首次正确通气时间作为次要终点进行记录。
结果
在正常和困难气道条件下，VieScope 和 GlideScope 在正确的气管导管位置方面没有显著差异。在正常气道设置中，VieScope 的首次通过成功率超过 91%。VieScope 在困难气道中的成功率与 GlideScope 相当，但插管时间和通气时间明显更长。
结论
VieScope 和 GlideScope 在正常和困难气道中均具有较高的成功率。两组均未发生未识别的食管插管。尽管 VieScope 组的插管总时间较长，但在文献中给出的可接受范围内。这项模拟研究的结果表明，VieScope 可能是 PPE 全身穿戴条件下气管插管的一种可接受的替代方法。
试验注册
该研究在德国临床试验注册处 www.drks.de 进行了注册（注册日期：2020 年 11 月 9 日；试验 ID：DRKS00023406）。
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