Videolaryngoscopy Versus Direct Laryngoscopy in Simulated Pediatric Intubation
Videolaryngoscopy Versus Direct Laryngoscopy in Simulated Pediatric Intubation
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DOI：
10.1016/j.annemergmed.2012.09.008
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发表时间：
2013-03-01
影响因子：
6.2
通讯作者：
Deutsch, Ellen S.
中科院分区：
文献类型：
--
作者：
Donoghue, Aaron J.;Ades, Anne M.;Deutsch, Ellen S.
研究目的：我们确定在模拟患者中，与直接喉镜相比，视频喉镜是否导致首次插管成功率和声门可视化改善。方法：这是一项单一机构的横断面研究。儿科急救医学的研究员和教职员工被邀请参加。每个受试者在3个模拟器(新生儿、婴儿、成人)上使用视频喉镜进行插管；每个模拟器由每个受试者在使用和不使用视频的情况下插管。主要结果是第一次插管成功；次要结果是声门开放分数(POGO)。结果：26名参与者进行了156次插管；148次插管获得完整数据。新生儿首次尝试成功率为88%；婴儿为79%；成人为60%。在成人模拟器中，使用视频喉镜的受试者首次尝试成功率为81%，而使用直接喉镜的受试者为39%(差异43%；95%可信区间[CI]18%至67%)。在新生儿或婴儿模拟器中，视频喉镜和直接喉镜的首次尝试成功率没有差异。在3个模拟器中，视频喉镜的使用都导致POGO评分增加，新生儿模拟器中的差异为25%(95%CI 2%至48%)，婴儿模拟器中的差异为23%(95%CI 2%至48%)，成人模拟器中的差异为42%(95%CI 18%至66%)。结论：视频喉镜与儿童急诊医生在成人模拟器上进行插管时的首次尝试成功率有关。所有3个模拟器的POGO评分在视频喉镜下均有显著改善。访问数/每百万人：Reach for[Ann Emerg2013；61：271-277。]
Study objective: We determine whether videolaryngoscopy results in a higher prevalence of first-attempt intubation success and improved glottic visualization than direct laryngoscopy when performed by pediatric emergency medicine providers in simulated patients.Methods: This was a cross-sectional study at a single institution. Fellows and faculty in pediatric emergency medicine were invited to participate. Each subject performed intubations on 3 simulators (newborn, infant, adult), using a videolaryngoscope; each simulator was intubated by each subject with and without use of video. Primary outcome was first-attempt intubation success; secondary outcome was percentage of glottic opening score (POGO).Results: Twenty-six participants performed 156 intubations; complete data were available for 148 intubations. First-attempt success in the neonate was 88%; in the infant, 79%; and in the adult, 60%. In the adult simulator, videolaryngoscopy use showed a first-attempt success in 81% of subjects compared with 39% with direct laryngoscopy (difference 43%; 95% confidence interval [Cl] 18% to 67%). There was no difference in first-attempt success rates between videolaryngoscopy and direct laryngoscopy in the newborn or infant simulators. Videolaryngoscopy use led to increased POGO scores in all 3 simulators, with a difference of 25% (95% Cl 2% to 48%) in newborn simulators, 23% (95% CI 2% to 48%) in infant simulators, and 42% (95% Cl 18% to 66%) in adult simulators.Conclusion: Videolaryngoscopy was associated with greater first-attempt success during intubation by pediatric emergency physicians on an adult simulator. POGO score was significantly improved in all 3 simulators with videolaryngoscopy. [Ann Emerg Med. 2013;61:271-277.]