Stuby Loric, Mühlemann Elisa, Jampen Laurent, Thurre David, Siebert Johan N, Suppan Laurent
Genève TEAM Ambulances, Emergency Medical Services, CH-1201 Geneva, Switzerland.
ESAMB-École Supérieure de Soins Ambulanciers, College of Higher Education in Ambulance Care, CH-1231 Conches, Switzerland.
Children (Basel). 2023 Jan 12;10(1):148. doi: 10.3390/children10010148.
Most pediatric out-of-hospital cardiac arrests (OHCAs) are caused by hypoxia, which is generally consecutive to respiratory failure. To restore oxygenation, prehospital providers usually first use basic airway management techniques, i.e., bag-valve-mask (BVM) devices. These devices present several drawbacks, most of which could be avoided using supraglottic airway devices. These intermediate airway management (IAM) devices also present significant advantages over tracheal intubation: they are associated with higher success and lower complication rates in the prehospital setting. There are, however, few data regarding the effect of early IAM in pediatric OHCA. This paper details the protocol of a trial designed to evaluate the impact of this airway management strategy on ventilation parameters through a simulated, multicenter, randomized, crossover trial. The hypothesis underlying this study protocol is that early IAM without prior BVM ventilations could improve the ventilation parameters in comparison with the standard approach, which consists in BVM ventilations only.
大多数儿童院外心脏骤停（OHCA）是由缺氧引起的，而缺氧通常是呼吸衰竭的后续结果。为了恢复氧合，院前急救人员通常首先使用基本气道管理技术，即袋阀面罩（BVM）装置。这些装置存在几个缺点，其中大多数可以通过使用声门上气道装置来避免。这些中级气道管理（IAM）装置与气管插管相比也具有显著优势：在院前环境中，它们的成功率更高，并发症发生率更低。然而，关于早期IAM在儿童OHCA中的作用的数据很少。本文详细介绍了一项试验方案，该试验旨在通过模拟、多中心、随机、交叉试验评估这种气道管理策略对通气参数的影响。本研究方案的基本假设是，与仅进行BVM通气的标准方法相比，早期IAM且不进行事先的BVM通气可以改善通气参数。
