评估 E/C、T/E 和钩技术（一种新提出的技术）进行球囊面罩通气的质量。

Evaluation the quality of bag-mask ventilation by E/C, T/E and hook technique (a new proposed technique).

机构信息

Emergency and trauma care research center, Tabriz University of Medical Sciences, Tabriz, Iran.

Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

BMC Anesthesiol. 2023 Nov 23;23(1):384. doi: 10.1186/s12871-023-02349-w.

DOI:10.1186/s12871-023-02349-w

PMID:37996828

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10666307/

Abstract

BACKGROUND

Bag-Mask Ventilation (BMV) is a crucial skill in managing emergency airway situations and induction of general anesthesia. Ensuring proficient BMV execution is imperative for healthcare providers. Various techniques exist for performing BMV. This study aims to compare the quality of ventilation achieved using the E/C technique, Thenar Eminence (T/E) technique and a novel approach referred to as the hook technique. The goal is to identify the most effective single-person BMV method.

METHOD

We conduct a pilot study on manikins involving 63 medical staff members who used the hook technique for ventilation. Subsequently, we obtained ethical approval and patient guardian consent to perform the study on 492 emergency department (ED) patients. These patients were randomly divided into three groups, with each group subjected to one three ventilation techniques. The study focused on patients requiring reliable airway management for rapid sequence intubation (RSI). Ventilation was administrated using bag-mask device connected to the capnograph. End-tidal CO2 (ETCO2) levels were recorded. Demographic data were collected and analyzed by SPSS software version 22. Success rates were reported as frequency (percentage) as well as mean ± standard deviation.

RESULT

Comparing partial pressure of CO2 (PCO2) results obtained via capnography between T/E, E/C and hook techniques, we found that the successful ventilation rate was 87.2% for T/E, 89.6% for E/C, and 93.3% for the hook methods. The hook method demonstrated significantly higher success rate compared to the other two techniques (P-value = 0.038). Furthermore, we observed statistically significant trends in PCO2 changes between measurements both within and between groups (P-value < 0/001).

CONCLUSION

Our study indicates that the hook method achieved notably higher success rate in ventilation compared to the T/E and E/C methods. This suggests that the hook method, which involves a chin lift maneuver while securely fitting the mask, could serve as a novel BMV technique, particularly for resuscitation with small hands for a prolonged use without fatigue and finger discomfort. Our finding contributes to the development of a new BMV method referred to as the hook technique.

TRIAL REGISTRATION

IRCT registration number: IRCT20121010011067N5. URL of trial registry record: https://www.irct.ir/trial/57420 .

摘要

背景

球囊面罩通气（BMV）是管理紧急气道情况和全身麻醉诱导的关键技能。确保熟练执行 BMV 对医疗保健提供者至关重要。有各种技术可用于执行 BMV。本研究旨在比较使用 E/C 技术、鱼际隆起（T/E）技术和一种称为钩技术的新方法实现的通气质量。目标是确定最有效的单人 BMV 方法。

方法

我们在模拟人上进行了一项试点研究，涉及 63 名使用钩技术进行通气的医务人员。随后，我们获得了伦理批准，并获得了患者监护人的同意，对 492 名急诊部（ED）患者进行了这项研究。这些患者被随机分为三组，每组接受三种通气技术中的一种。该研究侧重于需要可靠气道管理以进行快速序列插管（RSI）的患者。使用连接到呼气末二氧化碳（ETCO2）描记器的袋面罩设备进行通气。记录 ETCO2 水平。收集并使用 SPSS 软件版本 22 分析人口统计学数据。成功率以频率（百分比）和平均值±标准差报告。

结果

比较 T/E、E/C 和钩技术通过呼气末二氧化碳（CO2）分压（PCO2）记录获得的结果，我们发现 T/E 的成功通气率为 87.2%，E/C 为 89.6%，钩法为 93.3%。钩法与其他两种技术相比，成功率显著更高（P 值=0.038）。此外，我们观察到组内和组间测量的 PCO2 变化均呈统计学显著趋势（P 值<0/001）。