Merola Federica, Messina Simone, Santonocito Cristina, Sanfilippo Marco, Sanfilippo Giulia, Lombardo Federica, Schembari Giovanni, Murabito Paolo, Rubulotta Francesca, Sanfilippo Filippo
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.
J Clin Med. 2024 Dec 19;13(24):7760. doi: 10.3390/jcm13247760.
Simulation offers the opportunity to train healthcare professionals in complex scenarios, such as those with as traumatized patients. We conducted an observational cross-sectional research simulating trauma with cervical immobilization. We compared five techniques/devices: direct laryngoscopy (DL), videolaryngoscopy (VLS, Glidescope or McGrath), combined laryngo-bronchoscopy intubation (CLBI) and articulating video stylet (ProVu). The primary outcomes were as follows: (1) success rate (SR) by third attempt (each lasting up to 60 s), and (2) corrected time-to-intubation (cTTI, accounting for failed attempts). In a single center, we enrolled 42 consultants experienced in DL/VLS, but reporting no experience with ProVu, and hypothesized that ProVu would have offered encouraging performances. By the third attempt, ProVu had a SR of 73.8%, identical to Glidescope ( = 1.00) and inferior only to McGrath (97.6%; = 0.003). The cTTI (seconds) of ProVu (57.5 [45-174]) was similar to Glidescope (51.2 [29-159]; = 0.391), inferior to DL and McGrath (31.0 [22-46]; = 0.001; and 49.6 [27-88]; = 0.014, respectively), and superior to CLBI (157.5 [41-180]; = 0.023). Conclusions: In consultants with no experience, as compared to DL and VLS, the video stylet ProVu showed encouraging results under simulated circumstances of cervical immobilization. The results should be interpreted in light of the participants being novices to ProVu and skilled in DL/VLS. Adequate training is required before the clinical introduction of any airway device.
模拟为医疗保健专业人员提供了在复杂场景中进行培训的机会，例如那些有创伤患者的场景。我们进行了一项观察性横断面研究，模拟颈椎固定的创伤情况。我们比较了五种技术/设备：直接喉镜检查（DL）、视频喉镜检查（VLS，Glidescope或McGrath）、联合喉-支气管镜插管（CLBI）和可弯曲视频探条（ProVu）。主要结果如下：（1）第三次尝试时的成功率（SR）（每次尝试持续最长60秒），以及（2）校正插管时间（cTTI，考虑失败的尝试）。在一个单一中心，我们招募了42名在DL/VLS方面有经验但没有ProVu经验的顾问，并假设ProVu会有令人鼓舞的表现。到第三次尝试时，ProVu的成功率为73.8%，与Glidescope相同（=1.00），仅低于McGrath（97.6%；=0.003）。ProVu的cTTI（秒）为57.5[45 - 174]，与Glidescope相似（51.2[29 - 159]；=0.391），低于DL和McGrath（分别为31.0[22 - 46]；=0.001和49.6[27 - 88]；=0.014），且优于CLBI（157.5[41 - 180]；=0.023）。结论：在没有经验的顾问中，与DL和VLS相比，视频探条ProVu在模拟颈椎固定的情况下显示出令人鼓舞的结果。鉴于参与者是ProVu的新手且在DL/VLS方面熟练，这些结果应予以解读。在任何气道设备临床应用之前都需要进行充分的培训。
