Sertcakacilar Gokhan, Bayrak Sunkar Kaya, Pektas Yaser, Bostanci Ipek, Yildiz Gunes Ozlem, Sabaz Mehmet Suleyman
Cleveland Clinic, Department of Outcomes Research, Cleveland, OH, USA.
Department of Anaesthesiology and Reanimation, University Of Health Sciences, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Turkey.
Indian J Anaesth. 2022 Feb;66(2):112-118. doi: 10.4103/ija.ija_802_21. Epub 2022 Feb 24.
During the coronavirus disease 2019 (COVID-19) pandemic, health care workers are at a high risk of infection from aerosols. In this study, we compared the ease of using the aerosol box (AB) with the traditional method during internal jugular vein cannulation attempts (IJVCA).
The study included 40 patients with COVID-19 who required central venous catheterisation during treatment in the ward. The patients were randomly allocated to one of the two protective equipment (PPE) groups and then randomly assigned to one of the five anaesthesiologists with at least 5 years of experience. Group P and A had both PPE and AB used, whereas Group P included patients where PPE was used alone. The physicians completed a survey after performing the procedure to evaluate the use of the AB.
The preparation for the procedure and procedure durations were observed to be statistically longer in Group P and A ( = 0.002 and = 0.001, respectively). The first attempt in Group P and A was unsuccessful in six patients, whereas the first attempt in Group P was unsuccessful in only two patients ( = 0.235). Anaesthesiologists described difficulty with manipulation during the procedure, discomfort using the box, and resulting cognitive load increase in Group P and A.
The IJVCA procedures were faster and easier and had greater satisfaction for physicians when the AB was not used. Also, the high complication rate, including carotid artery punctures and disruption of sterility and PPE, albeit not statistically significant, has clinical implications. Therefore, we do not recommend the use of ABs for IJVCA.
在2019年冠状病毒病（COVID-19）大流行期间，医护人员面临气溶胶感染的高风险。在本研究中，我们比较了在颈内静脉置管尝试（IJVCA）过程中使用气溶胶箱（AB）与传统方法的便捷程度。
该研究纳入了40例在病房治疗期间需要进行中心静脉置管的COVID-19患者。患者被随机分配到两个防护设备（PPE）组之一，然后再随机分配给5名经验至少5年的麻醉医生之一。P组和A组同时使用PPE和气溶胶箱，而P组仅包括单独使用PPE的患者。医生在完成操作后填写一份调查问卷，以评估气溶胶箱的使用情况。
观察到P组和A组的操作准备时间和操作持续时间在统计学上更长（分别为P = 0.002和P = 0.001）。P组和A组有6例患者首次尝试失败，而P组仅有2例患者首次尝试失败（P = 0.235）。麻醉医生描述了P组和A组在操作过程中操作困难、使用箱子时不适以及由此导致的认知负荷增加。
不使用气溶胶箱时，IJVCA操作对医生来说更快、更容易且满意度更高。此外，尽管无统计学意义，但包括颈动脉穿刺以及无菌和PPE破坏在内的高并发症发生率具有临床意义。因此，我们不建议在IJVCA中使用气溶胶箱。
