Faculty of Medicine, University of Cologne, Albertus-Magnus-Platz 1, 50931, Cologne, Germany.
Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany.
BMC Anesthesiol. 2023 Aug 14;23(1):273. doi: 10.1186/s12871-023-02234-6.
Recently, a non-commercial oxygenation laryngoscope was able to maintain apneic oxygenation during simulated intubation efforts. Since that prototype was 3 mm wider than a standard Macintosh laryngoscope blade, the intubation performance of this device may differ from standard blades. A new prototype of an oxygenation laryngoscope was developed, consisting of a standard-size Macintosh blade and a fixed oxygen supply line to the side. Actually, it is unclear at which point of this blade the oxygen supply line should end to facilitate the best possible oxygen supply for apneic oxygenation.
In this simulation study using a standardized human airway manikin, the efficacy of apneic oxygenation by oxygen insufflation using standard and modified Macintosh blades was compared: a standard Macintosh blade without oxygen supply line as control, one with an additional oxygen supply line ending proximal near the handle, one with the line ending at the middle of the blade, and one with the line ending near the tip. A preoxygenated test lung was connected to an oximeter with a flow rate of 200ml/min, simulating oxygen consumption of a male adult, and to the trachea of an anatomically correctly shaped airway manikin. Apneic oxygenation was performed and oxygen content was measured over a 20-minutes observation period. Experiments were repeated five times for each laryngoscope blade.
Oxygen percentage in the test lung dropped from 100 ± 0% at the start of the experiment to 53 ± 1.5% in the room air control group (p < 0.001 compared to all other groups), and to 74 ± 2.5% in the proximal oxygen line group, whereas oxygen percentage remained at 100% in both the medium and distal oxygen line groups (p = 1 between these groups; p < 0.001 between all other groups).
In this simulation study with a preoxygenated airway manikin, the use of a modified Macintosh laryngoscope blade with oxygen line attached at the tip or at the middle were able to maintain apneic oxygenation without measurable drop of oxygen content over 20 min. Proximal placement of the oxygen supply line still showed an advantage against room air, however it did not completely prevent room air from entering the airway.
Not applicable.
最近，一种非商业性的氧合喉镜能够在模拟插管过程中维持窒息时的氧合。由于该原型比标准的 Macintosh 喉镜叶片宽 3 毫米，因此该设备的插管性能可能与标准叶片不同。开发了一种新的氧合喉镜原型，由标准大小的 Macintosh 叶片和固定的供氧管组成。实际上，尚不清楚供氧管应在叶片的哪个位置结束，以方便窒息时的最佳氧合。
在这项使用标准化人体气道模型的模拟研究中，比较了标准和改良的 Macintosh 叶片进行窒息氧合的效果：以无供氧管的标准 Macintosh 叶片作为对照，一个带有附加供氧管，近端靠近手柄，一个带有供氧管，中端结束，一个带有供氧管，靠近尖端结束。将预充氧的测试肺连接到一个流量为 200ml/min 的血氧计，模拟成年男性的耗氧量，并连接到解剖形状正确的气道模型的气管。进行窒息氧合，并在 20 分钟的观察期内测量氧气含量。每个喉镜叶片重复实验 5 次。
实验开始时，测试肺中的氧气百分比从 100±0%降至房间空气对照组的 53±1.5%（与所有其他组相比，p<0.001），而在近端供氧管组中降至 74±2.5%，而在中、远段供氧管组中氧气百分比保持在 100%（两组之间 p=1；与所有其他组相比，p<0.001）。
在这项使用预充氧气道模型的模拟研究中，使用带有尖端或中端供氧管的改良 Macintosh 喉镜叶片能够在 20 分钟内维持窒息时的氧合，而氧气含量无明显下降。近端放置供氧管仍显示出优于空气的优势，但不能完全防止空气进入气道。
不适用。
