PDF(Pubmed)
Abstract：
BACKGROUND: Patients under cardiopulmonary resuscitation (CPR) are at high risk of aspirating gastric contents. Nasogastric tube insertion (NGTI) after tracheal intubation is usually performed blindly. This sometimes causes laryngopharyngeal mucosal injury (LPMI), leading to severe bleeding. This study clarified the incidence of LPMI due to blind NGTI during CPR.
METHODS: We retrospectively analyzed 84 patients presenting with cardiopulmonary arrest on arrival, categorized them into a Smooth group (Smooth; blind NGTI was possible within 2 min), and Difficult group (blind NGTI was not possible), and consequently performed video laryngoscope-assisted NGTI. The laryngopharyngeal mucosal condition was recorded using video laryngoscope. Success rates and insertion time for the Smooth group were calculated. Insertion number and LPMI scores were compared between the groups. Each regression line of outcome measurements was obtained using simple regression analysis. We also analyzed the causes of the Difficult group, using recorded video laryngoscope-assisted videos.
RESULTS: The success rate was 78.6% (66/84). NGTI time was 48.8 ± 4.0 s in the Smooth group. Insertion number and injury scores in the Smooth group were significantly lower than those in the Difficult group. The severity of LPMI increased with NGT insertion time and insertion number.
CONCLUSIONS: Whenever blind NGTI is difficult, switching to other methods is essential to prevent unnecessary persistence.
METHODS: We retrospectively analyzed 84 patients presenting with cardiopulmonary arrest on arrival, categorized them into a Smooth group (Smooth; blind NGTI was possible within 2 min), and Difficult group (blind NGTI was not possible), and consequently performed video laryngoscope-assisted NGTI. The laryngopharyngeal mucosal condition was recorded using video laryngoscope. Success rates and insertion time for the Smooth group were calculated. Insertion number and LPMI scores were compared between the groups. Each regression line of outcome measurements was obtained using simple regression analysis. We also analyzed the causes of the Difficult group, using recorded video laryngoscope-assisted videos.
RESULTS: The success rate was 78.6% (66/84). NGTI time was 48.8 ± 4.0 s in the Smooth group. Insertion number and injury scores in the Smooth group were significantly lower than those in the Difficult group. The severity of LPMI increased with NGT insertion time and insertion number.
CONCLUSIONS: Whenever blind NGTI is difficult, switching to other methods is essential to prevent unnecessary persistence.
摘要：
背景：接受心肺复苏（CPR）的患者吸入胃内容物的风险很高。气管插管后插入鼻胃管（NGTI）通常是盲目的。这有时会导致喉咽粘膜损伤（LPMI），导致严重出血.这项研究阐明了CPR期间由于盲目NGTI引起的LPMI的发生率。
方法：我们回顾性分析了84例到达时出现心肺骤停的患者，将它们归类为平滑组（平滑；在2分钟内可能出现盲NGTI），和困难组（盲目的NGTI是不可能的），并因此进行了视频喉镜辅助NGTI。使用视频喉镜记录喉咽粘膜状况。计算Smooth组的成功率和插入时间。比较两组的插入数和LPMI评分。使用简单回归分析获得结果测量的每个回归线。我们还分析了困难群体的原因，使用录制的视频喉镜辅助视频。
结果：成功率为78.6%(66/84)。Smooth组NGTI时间为48.8±4.0s。Smooth组的插入次数和损伤评分明显低于困难组。LPMI的严重程度随NGT插入时间和插入次数的增加而增加。
结论：每当盲NGTI困难时，切换到其他方法对于防止不必要的持久性至关重要。
方法：我们回顾性分析了84例到达时出现心肺骤停的患者，将它们归类为平滑组（平滑；在2分钟内可能出现盲NGTI），和困难组（盲目的NGTI是不可能的），并因此进行了视频喉镜辅助NGTI。使用视频喉镜记录喉咽粘膜状况。计算Smooth组的成功率和插入时间。比较两组的插入数和LPMI评分。使用简单回归分析获得结果测量的每个回归线。我们还分析了困难群体的原因，使用录制的视频喉镜辅助视频。
结果：成功率为78.6%(66/84)。Smooth组NGTI时间为48.8±4.0s。Smooth组的插入次数和损伤评分明显低于困难组。LPMI的严重程度随NGT插入时间和插入次数的增加而增加。
结论：每当盲NGTI困难时，切换到其他方法对于防止不必要的持久性至关重要。
