日本广岛院前气管插管中视频喉镜与麦金托什喉镜的比较研究

A comparative study of Video laryngoscope vs Macintosh laryngoscope for prehospital tracheal intubation in Hiroshima, Japan.

作者信息

Santou N, Ueta H, Nakagawa K, Hata K, Kusunoki S, Sadamori T, Takyu H, Tanaka H

机构信息

Research Institute of Disaster Management and EMS, Kokushikan University,Tokyo, Japan.

Department of Emergency Medical System, Graduate School, Kokushikan University , Tokyo, Japan.

出版信息

Resusc Plus. 2022 Dec 16;13:100340. doi: 10.1016/j.resplu.2022.100340. eCollection 2023 Mar.

DOI:10.1016/j.resplu.2022.100340

PMID:36582475

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9792877/

Abstract

BACKGROUND

In Japan, there are no studies comparing endotracheal intubation performed by emergency medical technicians (EMTs) during out-of-hospital cardiac arrest (OHCA) using a Macintosh laryngoscope and a video laryngoscope.

OBJECTIVE

The purpose of this study was to compare the success rate, complication rate, return of spontaneous circulation (ROSC), neurological prognosis (CPC1-2) and regional differences between Video laryngoscope (VL) and Macintosh laryngoscope (ML) for OHCA patients.

METHOD

This study is a retrospective cohort study using 10,067 OHCA data extracted from the national Utstein Form and emergency medical transport data. The primary endpoint was the success rate of tracheal intubation and the complication rate and the secondary endpoints were the incidence of ROSC and CPC1-2.

RESULTS

A total of 885 tracheal Intubated OHCA patients were enrolled in this study. The success rate was 94.1% (490/521) in the VL group and 89.3% (325/364) in the ML group (RR, 1.05; 95%CI, 1.01-1.10, = 0.01), the VL group shows significantly higher success rate than that of the ML group. In the complication rates, oesophageal intubation occurred in 0.2% (1/521) of in the VL group and in 6.0% (22/364) in the ML group, Indicating significantly higher complication rates in the ML group compared with the VL group (RR, 1.06; 95% CI, 1.03-1.09, < 0.001). The ROSC rate and CPC1-2 rate are similar among the groups.

CONCLUSION

Our data suggest that using VL had a little advantage with a higher success rate and lower complication rate. Further discussion is necessary for the future development of Emergency Medical Services (EMS) intubation devices.

摘要

背景

在日本，尚无关于院外心脏骤停（OHCA）期间急诊医疗技术人员（EMT）使用麦金托什喉镜和视频喉镜进行气管插管的比较研究。

目的

本研究旨在比较视频喉镜（VL）和麦金托什喉镜（ML）用于OHCA患者的成功率、并发症发生率、自主循环恢复（ROSC）、神经学预后（CPC1 - 2）及区域差异。

方法

本研究是一项回顾性队列研究，使用从全国乌斯坦表格和紧急医疗转运数据中提取的10,067例OHCA数据。主要终点是气管插管成功率和并发症发生率，次要终点是ROSC和CPC1 - 2的发生率。

结果

本研究共纳入885例接受气管插管的OHCA患者。VL组成功率为94.1%（490/521），ML组为89.3%（325/364）（RR，1.05；95%CI，1.01 - 1.10，P = 0.01），VL组成功率显著高于ML组。在并发症发生率方面，VL组食管插管发生率为0.2%（1/521），ML组为6.0%（22/364），表明ML组并发症发生率显著高于VL组（RR，1.06；95%CI，1.03 - 1.09，P < 0.001）。各组间ROSC率和CPC1 - 2率相似。