Sinha Aparna, Punhani Dinesh, Sharma Abhishek, Dhakate Kumar Gaurav, Garg Nivedita, Patro Sangeeta
Department of Anesthesia, Max Institute of Laparoscopy, Endoscopy and Bariatric Surgery, Max Super Speciality Hospital, New Delhi, India.
J Minim Access Surg. 2023 Apr-Jun;19(2):234-238. doi: 10.4103/jmas.jmas_11_22.
Aerosol protection equipment aim at protecting the anaesthesiologist, from aerosol-borne infections, namely, severe acute respiratory syndrome corona virus-2.
We improvised the first-generation intubation box (IB) by increasing its dimensions, including heat and moisture exchanger with filter, suction catheter, and attaching arm sleeves to make a modified intubation box (MIB). The impact of IB, MIB and transparent sheets (TS) on the patient outcomes during airway management was evaluated.
A significant difference in median (interquartile range in minutes) was observed in time to intubate between IB (4 [4-5]); TS (0.5 [0.3-0.5]) and MIB (0.3 [0.3-1.5]): P = 0.004); and airway devices; McCoy (0.5 [0.3-2]), CMac (0.5 [0.3-1.5]): P = 0.004. First-pass success was 100% with the TS, whereas more than three attempts were required with IB 66.7% and 5.2% with MIB. Video laryngoscope was associated with less airway-related adverse events (ARAEs). The need for mask ventilation (and hence possible aerosolisation) was maximum with IB. All the ARAEs resolved uneventfully. No breach of personal protective equipment was observed; none of the health-care professionals involved in patient care developed any symptoms suggestive of COVID-19.
Video laryngoscope is favourable for managing airway in COVID-19 times. In view of the ongoing pandemic and added protection that it offers, it is worthwhile to include the MIB in the armamentarium for managing the airway of patients with COVID-19.
气溶胶防护设备旨在保护麻醉医生免受气溶胶传播感染，即严重急性呼吸综合征冠状病毒2感染。
我们通过增加第一代插管箱（IB）的尺寸进行改进，包括带有过滤器的热湿交换器、吸引导管，并附加臂套制作成改良插管箱（MIB）。评估了IB、MIB和透明片（TS）在气道管理期间对患者结局的影响。
在插管时间方面观察到显著差异（中位数，分钟的四分位间距），IB为4（4 - 5）；TS为0.5（0.3 - 0.5）；MIB为0.3（0.3 - 1.5）：P = 0.004）；以及气道设备方面，麦考伊喉镜（0.5（0.3 - 2））、CMac喉镜（0.5（0.3 - 1.5））：P = 0.004。TS的首次插管成功率为100%，而IB需要超过三次尝试的比例为66.7%，MIB为5.2%。视频喉镜与较少的气道相关不良事件（ARAEs）相关。IB进行面罩通气（以及因此可能产生气溶胶）的需求最大。所有ARAEs均顺利解决。未观察到个人防护设备的破损；参与患者护理的医护人员均未出现任何提示COVID - 19的症状。
视频喉镜有利于在COVID - 19时期管理气道。鉴于当前的大流行以及它提供的额外保护，将MIB纳入用于管理COVID - 19患者气道的设备库是值得的。
