Department of Anaesthesia and Critical Care, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK.
Department of Emergency Medicine, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK.
Br J Anaesth. 2023 Sep;131(3):434-438. doi: 10.1016/j.bja.2023.06.057. Epub 2023 Jul 26.
The recently published INTUBE study subanalysis and DEVICE trial findings both demonstrate a clear benefit of videolaryngoscopy over direct laryngoscopy in facilitating tracheal intubation of patients in the emergency department and ICU. We consider the increasing evidence supporting the use of videolaryngoscopy, the possible reasons behind its relatively slow adoption into clinical practice, and the potential role of the hyperangulated videolaryngoscope blade. We discuss the significance of improved first-pass tracheal intubation success in reducing the overall risk of complications in critically ill patients. Additionally, we address the need for specific training in videolaryngoscopy in order to maximise patient benefit, and propose that adequate training and rehearsal opportunities in videolaryngoscopy can only be realised by widespread and regular use wherever the clinical setting.
最近发表的 INTUBE 研究子分析和 DEVICE 试验结果均表明，视频喉镜在急诊科和 ICU 中辅助患者进行气管插管方面明显优于直接喉镜。我们考虑到越来越多的证据支持使用视频喉镜，以及其在临床实践中相对缓慢采用的可能原因，以及超角度视频喉镜刀片的潜在作用。我们讨论了提高首次通过气管插管成功率在降低危重病患者整体并发症风险方面的意义。此外，我们还讨论了在视频喉镜方面进行特定培训的必要性，以最大限度地提高患者的受益，并提出只有在临床环境中广泛和定期使用视频喉镜才能实现充分的培训和演练机会。
