Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial
Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial
复制标题
DOI：
10.1155/2019/7306204
复制
发表时间：
2019-08-20
影响因子：
1.2
通讯作者：
Szarpak, Lukasz
中科院分区：
文献类型：
--
作者：
Evrin, Togay;Smereka, Jacek;Szarpak, Lukasz
介绍。气道管理是复苏的关键要素之一。气管插管仍然被认为是复苏期间气道管理的金标准。的目标。本研究的目的是比较标准化人体模型在心肺复苏条件下气道困难急诊插管时不同气管插管方法的成功率和插管时间。方法。本研究设计为前瞻性、随机、交叉模拟研究。参与调查的46名护理人员至少有5年的急救医疗服务经验。参与者在困难的气道条件下进行气管插管，并使用LUCAS3胸压系统进行持续胸压。采用三种气管插管方法：(1)标准Macintosh喉镜；(2)标准喉镜和标准花冠；(3)标准喉镜和新型大口径喉镜。结果。标准弓组和新弓组插管成功率为100%，不使用弓组插管成功率为86.9% （P=0.028）。第一次插管成功率，新气囊组为91.3%，标准气囊组为73.9%，无气囊组仅为23.9%。新冠组中位插管时间最短，为29 s（四分位数间距[IQR]: 25-38）；标准大鼠组和无大鼠组的平均时间分别为38秒（IQR:31-44.5）和47.5秒（IQR:36-58）。无花束组的易用性最低（85分，IQR值为63 ~ 88），标准花束组的易用性平均（44分，IQR值为30 ~ 51），新花束组的易用性最高（32分，IQR值为19 ~ 41）。结论。在这项以人体模型为基础的研究中，与标准的假体假体相比，医护人员能够在更短的时间内使用新的假体假体假体进行气管插管，并且具有更高的疗效。
Introduction. Airway management is one of key elements of resuscitation. Endotracheal intubation is still considered the gold standard for airway management during resuscitation. Aim. The aim of the study was to compare success rates and intubation time of different endotracheal intubation methods during emergency intubation with difficult airways in the conditions of cardiopulmonary resuscitation in a standardized manikin model. Methods. The study was designed as a prospective, randomized, cross-over simulation study. It involved 46 paramedics with at least 5 years of experience in Emergency Medical Service. The participants performed endotracheal intubation under difficult airway conditions during continuous chest compression, implemented with the LUCAS3 chest compression system. Three methods of tracheal intubation were applied: (1) standard Macintosh laryngoscope without a bougie stylet; (2) standard laryngoscope and a standard bougie stylet; (3) standard laryngoscope and a new bougie stylet. Results. The overall intubation success rate was 100% in the standard bougie and new bougie groups and lower (86.9%) when no bougie stylet was used (P=0.028). The intubation success rate with the 1st attempt equalled 91.3% for the new bougie group, 73.9% for standard bougie, and only 23.9% in the no-bougie group. The median intubation time was shortest in the new bougie group, where it amounted to 29 s (interquartile range [IQR]: 25-38); the time equalled 38s (IQR:31-44.5) in the standard bougie group and 47.5s (IQR:36-58) in the no-bougie group. The ease of use was lowest in the no-bougie group (85, IQR:63-88), average in the standard bougie group (44, IQR:30-51), and highest in the new bougie stylet group (32, IQR:19-41). Conclusion. In this manikin-based study, paramedics were able to perform endotracheal intubation with higher efficacy and in a shorter time using the new bougie stylet as compared with the standard bougie stylet.