在使用高角度可视喉镜进行模拟气管插管时，刚性和可弯曲视频插管芯的比较。

Comparison of Rigid and Articulating Video Stylets During Simulated Endotracheal Intubation With Hyperangulated Video Laryngoscopy.

机构信息

Department of Emergency Medicine, Allegheny Health Network, Erie, Pennsylvania.

出版信息

J Emerg Med. 2023 Mar;64(3):315-320. doi: 10.1016/j.jemermed.2023.01.007. Epub 2023 Mar 14.

DOI:10.1016/j.jemermed.2023.01.007

PMID:36925443

Abstract

BACKGROUND

Endotracheal tube delivery through the vocal cords can be challenging with hyperangulated video laryngoscopy due to the acute angle around the tongue and surrounding airway structures. Articulating video stylets may mitigate this issue by equipping an endotracheal tube stylet with an operator-controlled articulating end that has an additional camera at the tip.

OBJECTIVES

We compared operator-reported ease of intubation between the traditional rigid stylet (GlideRite Rigid Stylet, Verathon Inc., Bothell, WA) and the articulating video stylet (ProVu™ Video Stylet, Flexicare Inc., Irvine, CA) with a hyperangulated video laryngoscope (GlideScope, Verathon Inc., Bothell, WA).

METHODS

Participants performed simulated intubation using a hyperangulated video laryngoscope with both stylets in random order. We compared operator-reported ease of intubation on a 0-100 visual analogue scale (VAS), best percentage of glottic opening (POGO), and time to intubation. We compared outcomes using a paired t-test or the asymptotic Wilcoxon-Pratt signed-rank test dependent on normality.

RESULTS

We enrolled a convenience sample of 16 emergency department attendings, residents, and physician assistant postgraduate trainees. The median operator-reported ease of intubation on VAS was 20 (interquartile range 9, 30) for the rigid stylet and 20 (10, 30) for the articulating video stylet (p = 0.832). However, the rigid stylet had a slightly shorter mean time to intubation compared with the articulating video stylet, 6.9 (standard deviation 2.5) vs. 10.3 (4.1) s, respectively (p = 0.017). POGO was similar between groups.

CONCLUSIONS

During simulated endotracheal intubation, the rigid and articulating video stylets had similar operator-reported ease of intubation.

摘要

背景

由于舌和周围气道结构的锐角，使用高角度视频喉镜时，通过声带插入气管导管可能具有挑战性。可弯曲的视频管芯可以通过为气管导管管芯配备一个带有操作员控制的可弯曲末端的管芯来解决此问题，该末端在尖端处具有额外的摄像头。

目的

我们比较了传统刚性管芯（GlideRite 刚性管芯，Verathon Inc.，Bothell，WA）和可弯曲的视频管芯（ProVu™视频管芯，Flexicare Inc.，Irvine，CA）与高角度视频喉镜（GlideScope，Verathon Inc.，Bothell，WA）在操作员报告的插管容易程度方面的差异。

方法

参与者使用两种管芯以随机顺序进行高角度视频喉镜模拟插管。我们比较了操作员报告的插管容易程度，使用 0-100 视觉模拟量表（VAS），最佳声门张开百分比（POGO）和插管时间进行比较。根据正态性，我们使用配对 t 检验或渐近 Wilcoxon-Pratt 符号秩检验来比较结果。

结果

我们招募了一个由 16 名急诊医生、住院医师和医师助理研究生组成的方便样本。刚性管芯的操作员报告 VAS 上插管容易程度的中位数为 20（四分位距 9，30），可弯曲视频管芯为 20（10，30）（p = 0.832）。但是，刚性管芯的插管时间明显短于可弯曲视频管芯，分别为 6.9（标准差 2.5）和 10.3（4.1）秒（p = 0.017）。两组的 POGO 相似。