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与其他正常气道气管插管技术相比的关节式视频喉镜:对无既往经验的会诊医生的模拟研究

Articulating Video Stylet Compared to Other Techniques for Endotracheal Intubation in Normal Airways: A Simulation Study in Consultants with No Prior Experience.

作者信息

Messina Simone, Merola Federica, Santonocito Cristina, Sanfilippo Marco, Sanfilippo Giulia, Lombardo Federica, Bruni Andrea, Garofalo Eugenio, Murabito Paolo, Sanfilippo Filippo

机构信息

Department of Anaesthesia and Intensive Care, Policlinico-San Marco University Hospital, Via S. Sofia n 78, 95123 Catania, Italy.

School of Anesthesia and Intensive Care, University "Magna Graecia", 88100 Catanzaro, Italy.

出版信息

J Clin Med. 2024 Jan 26;13(3):728. doi: 10.3390/jcm13030728.

Abstract

Simulation for airway management allows for acquaintance with new devices and techniques. Endotracheal intubation (ETI), most commonly performed with direct laryngoscopy (DL) or video laryngoscopy (VLS), can be achieved also with combined laryngo-bronchoscopy intubation (CLBI). Finally, an articulating video stylet (ProVu) has been recently introduced. A single-center observational cross-sectional study was performed in a normal simulated airway scenario comparing DL, VLS-Glidescope, VLS-McGrath, CLBI and ProVu regarding the success rate (SR) and corrected time-to-intubation (cTTI, which accounts for the SR). Up to three attempts/device were allowed (maximum of 60 s each). Forty-two consultants with no experience with ProVu participated (15 ± 9 years after training completion). The DL was significantly faster (cTTI) than all other devices ( = 0.033 vs. VLSs, and < 0.001 for CLBI and Provu), no differences were seen between the two VLSs ( = 0.775), and the VLSs were faster than CLBI and ProVu. Provu had a faster cTTI than CLBI ( = 0.004). The DL and VLSs showed similar SRs, and all the laryngoscopes had a higher SR than CLBI and ProVu at the first attempt. However, by the third attempt, the SR was not different between the DL/VLSs and ProVu ( = 0.241/ = 0.616); ProVu was superior to CLBI ( = 0.038). In consultants with no prior experience, ProVu shows encouraging results compared to DL/VLSs under simulated normal airway circumstances and further studies are warranted.

摘要

气道管理模拟有助于熟悉新设备和技术。气管插管(ETI)最常通过直接喉镜检查(DL)或视频喉镜检查(VLS)进行,也可通过联合喉镜-支气管镜插管(CLBI)实现。最后,一种可弯曲视频探条(ProVu)最近已被引入。在正常模拟气道场景中进行了一项单中心观察性横断面研究,比较了DL、VLS-Glidescope、VLS-McGrath、CLBI和ProVu在成功率(SR)和校正插管时间(cTTI,其考虑了SR)方面的差异。每种设备最多允许进行三次尝试(每次最长60秒)。42名没有ProVu使用经验的顾问参与了研究(培训完成后15±9年)。DL的cTTI明显快于所有其他设备(与VLS相比,P = 0.033,与CLBI和ProVu相比,P < 0.001),两种VLS之间没有差异(P = 0.775),VLS比CLBI和ProVu更快。ProVu的cTTI比CLBI快(P = 0.004)。DL和VLS的SR相似,所有喉镜在首次尝试时的SR均高于CLBI和ProVu。然而,到第三次尝试时,DL/VLS和ProVu之间的SR没有差异(P = 0.241/P = 0.616);ProVu优于CLBI(P = 0.038)。在没有先前经验的顾问中,与DL/VLS相比,在模拟正常气道情况下ProVu显示出令人鼓舞的结果,有必要进行进一步研究。

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