Effect of the use of an endotracheal tube and stylet versus an endotracheal tube alone on first-attempt intubation success: a multicentre, randomised clinical trial in 999 patients.
Effect of the use of an endotracheal tube and stylet versus an endotracheal tube alone on first-attempt intubation success: a multicentre, randomised clinical trial in 999 patients.
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使用气管插管和气管导管与单独使用气管插管对首次插管成功的影响：一项涉及999例患者的多中心随机临床试验
DOI：
10.1007/s00134-021-06417-y
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发表时间：
2021-06
影响因子：
38.9
通讯作者：
STYLETO trial group
中科院分区：
文献类型：
--
作者：
Jaber S;Rollé A;Godet T;Terzi N;Riu B;Asfar P;Bourenne J;Ramin S;Lemiale V;Quenot JP;Guitton C;Prudhomme E;Quemeneur C;Blondonnet R;Biais M;Muller L;Ouattara A;Ferrandiere M;Saint-Léger P;Rimmelé T;Pottecher J;Chanques G;Belafia F;Chauveton C;Huguet H;Asehnoune K;Futier E;Azoulay E;Molinari N;De Jong A;STYLETO trial group
气管插管期间常规使用管心针对首次尝试插管成功的影响尚不清楚。我们假设气管导管 + 管心针的首次插管成功率比单独使用气管导管更高。在这项在 32 个重症监护病房进行的多中心随机对照试验中，我们将患者随机分配至气管插管 + 管芯或单独气管插管（即无管芯）。主要结局是首次尝试插管成功的患者比例。次要结果是出现气管插管相关并发症的患者比例。评估了严重的不良事件，即与气管插管相关的外伤。修改后的意向治疗分析总共纳入了 999 名患者：501 名患者（50%）接受气管插管+ 管心针，498 名患者（50%）接受单独气管插管。气管导管 + 管芯组有 392 名患者（78.2%）首次尝试插管成功，单独气管导管组有 356 名患者（71.5%）首次尝试插管成功（绝对风险差异，6.7；95%CI 1.4–12.1；相对风险，1.10；95%CI 1.02–1.18； P = 0.01）。气管插管组共有 194 名患者（38.7%）出现气管插管相关并发症，而单独气管插管组有 200 名患者（40.2%）出现并发症（绝对风险差，− 1.5；95% CI − 7.5 至 4.6；相对风险，0.96；95% CI 0.83–1.12；P= 0.64)。严重不良事件的发生率分别为4.0%和3.6%（绝对风险差异，0.4；95%CI，-2.0至2.8；相对风险，1.10；95%CI 0.59-2.06。P = 0.76）。在接受气管插管的危重成人中，使用管心针可提高首次尝试插管的成功率。在线版本包含可在 10.1007/s00134-021-06417-y 获取的补充材料。
The effect of the routine use of a stylet during tracheal intubation on first-attempt intubation success is unclear. We hypothesised that the first-attempt intubation success rate would be higher with tracheal tube + stylet than with tracheal tube alone. In this multicentre randomised controlled trial, conducted in 32 intensive care units, we randomly assigned patients to tracheal tube + stylet or tracheal tube alone (i.e. without stylet). The primary outcome was the proportion of patients with first-attempt intubation success. The secondary outcome was the proportion of patients with complications related to tracheal intubation. Serious adverse events, i.e., traumatic injuries related to tracheal intubation, were evaluated. A total of 999 patients were included in the modified intention-to-treat analysis: 501 (50%) to tracheal tube + stylet and 498 (50%) to tracheal tube alone. First-attempt intubation success occurred in 392 patients (78.2%) in the tracheal tube + stylet group and in 356 (71.5%) in the tracheal tube alone group (absolute risk difference, 6.7; 95%CI 1.4–12.1; relative risk, 1.10; 95%CI 1.02–1.18; P = 0.01). A total of 194 patients (38.7%) in the tracheal tube + stylet group had complications related to tracheal intubation, as compared with 200 patients (40.2%) in the tracheal tube alone group (absolute risk difference, − 1.5; 95%CI − 7.5 to 4.6; relative risk, 0.96; 95%CI 0.83–1.12; P = 0.64). The incidence of serious adverse events was 4.0% and 3.6%, respectively (absolute risk difference, 0.4; 95%CI, − 2.0 to 2.8; relative risk, 1.10; 95%CI 0.59–2.06. P = 0.76). Among critically ill adults undergoing tracheal intubation, using a stylet improves first-attempt intubation success. The online version contains supplementary material available at 10.1007/s00134-021-06417-y.
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影响因子：
2.9
作者：
Russell DW;Casey JD;Gibbs KW;Dargin JM;Vonderhaar DJ;Joffe AM;Ghamande S;Khan A;Dutta S;Landsperger JS;Robison SW;Bentov I;Wozniak JM;Stempek S;White HD;Krol OF;Prekker ME;Driver BE;Brewer JM;Wang L;Lindsell CJ;Self WH;Rice TW;Semler MW;Janz D;PREPARE II Investigators
通讯作者：
PREPARE II Investigators
影响因子：
76.2
作者：
Janz, David R.;Casey, Jonathan D.;Rice, Todd W.
通讯作者：
Rice, Todd W.
影响因子：
120.7
作者：
Lascarrou, Jean Baptiste;Boisrame-Helms, Julie;Reignier, Jean
通讯作者：
Reignier, Jean
影响因子：
2.9
作者：
Patwa, Apeksh;Shah, Amit;Myatra, Sheila Nainan
通讯作者：
Myatra, Sheila Nainan
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y