Department of Anaesthesiology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
Expert Rev Med Devices. 2023 Feb;20(2):151-160. doi: 10.1080/17434440.2023.2174850. Epub 2023 Feb 6.
A previous study reported a shorter time to tracheal intubation by reducing percentage of glottic opening (POGO) view to <50% when intubating a normal adult airway using the Glidescope blade. We evaluate the efficacy of reducing POGO to <50% when intubating patients with rigid cervical immobilization using CMAC D blade.
One hundred and four adult patients were randomized to group POGO 100% or POGO <50% . Laryngoscopy was performed by advancing tip of the D blade at vallecula. POGO 100% was achieved by exerting upward force to displace epiglottis until glottic opening from the anterior commissure to inter arytenoid notch. POGO < 50% was acquired by withdrawing the D blade tip dorsally from vallecula. The primary outcome was time to intubation.
The median time (IQR) to successful intubation was 29 (25-35) seconds for group POGO < 50% and 34 (28-40) seconds for group with POGO 100% (difference in medians, 5 seconds; 95% confidence interval, 2 to 8, p = 0.003). Complications were minor.
Using the CMAC D blade with a reduced POGO in patients with cervical spine immobilization resulted in faster tracheal intubation.
The trial is registered at ClinicalTrial.gov (CT.gov identifier: NCT04833166).
先前的一项研究表明，在使用 Glidescope 叶片对正常成人气道进行插管时，将声门显露（POGO）视图减少到<50%可缩短气管插管时间。我们评估在使用 CMAC D 叶片对颈椎固定的患者进行插管时，将 POGO 减少到<50%的效果。
104 名成年患者被随机分为 POGO 100%组或 POGO <50%组。通过将 D 叶片尖端推进会厌谷进行喉镜检查。通过向上施加力使会厌移位，直到从前联合到杓状软骨间切迹的声门完全显露来实现 POGO 100%。通过将 D 叶片尖端从会厌谷向背部撤回来获得 POGO <50%。主要结局是插管时间。
POGO <50%组成功插管的中位数（IQR）时间为 29（25-35）秒，POGO 100%组为 34（28-40）秒（中位数差值，5 秒；95%置信区间，2 至 8，p = 0.003）。并发症轻微。
在颈椎固定的患者中使用 CMAC D 叶片并减小 POGO 可更快地进行气管插管。
该试验在 ClinicalTrial.gov（CT.gov 标识符：NCT04833166）上注册。
