Dembinski Rolf, Cordes Olaf, Scholtyschik Daniel
Dtsch Med Wochenschr. 2022 Jan;147(1-02):53-61. doi: 10.1055/a-1226-7928. Epub 2021 Dec 28.
Emergency cricothyrotomy is a live saving intervention to rapidly gain access to the airways in patients who cannot be intubated nor ventilated. Considering complications such as bleeding, thyroid and cricoid cartilage injury and creation of a false tract emergency cricothyrotomy should not be performed until non-invasive attempts including video laryngoscopy and the use of supraglottic airway devices have been exploited within a fixed difficult airway management algorithm. Methods of emergency cricothyrotomy can be differentiated in a catheter-over-needle, Seldinger-wire and surgical technique. However, success is less dependent from the choice of method but from individual experience and training. Despite a lack of evidence due to its infrequent use cricothyrotomy generally results in an acceptable success rate. In this review a selection of commercially available cricothyrotomy sets is presented, indications for their use are outlined and their handling is described.
紧急环甲膜切开术是一种挽救生命的干预措施，用于在无法插管或通气的患者中迅速建立气道通路。考虑到诸如出血、甲状腺和环状软骨损伤以及形成假道等并发症，在固定的困难气道管理流程中，应先尝试包括视频喉镜检查和使用声门上气道装置等非侵入性方法后，再进行紧急环甲膜切开术。紧急环甲膜切开术的方法可分为针管穿刺置管法、导丝引导法和手术法。然而，成功率较少取决于方法的选择，而更多取决于个人经验和培训。尽管由于其使用频率低而缺乏证据，但环甲膜切开术通常能取得可接受的成功率。在本综述中，介绍了一些市售的环甲膜切开套件，概述了其使用指征并描述了操作方法。
