背景:最近,非商业氧合喉镜能够在模拟插管期间维持呼吸暂停氧合.因为那个原型比标准麦金塔喉镜刀片宽3毫米,该装置的插管性能可能不同于标准刀片。开发了氧合喉镜的新原型,由标准尺寸的Macintosh刀片和固定的氧气供应线组成。事实上,目前尚不清楚该叶片的供氧线应在哪个位置终止,以促进呼吸暂停氧合的最佳供氧。
方法:在这项使用标准化人体气道人体模型的模拟研究中,比较了使用标准和改进的Macintosh叶片通过氧气吹入进行呼吸暂停氧合的功效:没有氧气供应线的标准Macintosh叶片作为对照,一个有一个额外的氧气供应管线,在手柄附近终止,一条线终止于刀片的中间,一条线在尖端附近结束。预充氧测试肺连接到血氧计,流速为200ml/min,模拟成年男性的耗氧量,以及解剖形状正确的气道人体模型的气管。在20分钟的观察期内进行呼吸暂停氧合并测量氧含量。对每个喉镜刀片重复实验五次。
结果:测试肺中的氧气百分比从实验开始时的100±0%下降到室内空气对照组的53±1.5%(与所有其他组相比,p<0.001),近端氧气管组为74±2.5%,而中氧线组和远端氧线组的氧百分比保持在100%(这些组间p=1;所有其他组间p<0.001)。
结论:在这项使用预充氧气道人体模型的模拟研究中,使用改良的Macintosh喉镜刀片,在尖端或中间连接有氧气管线,能够在20分钟内保持呼吸暂停氧合,而不会出现可测量的氧含量下降。氧气供应管线的近端放置仍然显示出对室内空气的优势,然而,它并没有完全阻止室内空气进入气道。
背景:不适用。
Recently, a non-commercial oxygenation
laryngoscope was able to maintain apneic oxygenation during simulated intubation efforts. Since that prototype was 3 mm wider than a standard Macintosh
laryngoscope blade, the intubation performance of this device may differ from standard blades. A new prototype of an oxygenation
laryngoscope was developed, consisting of a standard-size Macintosh blade and a fixed oxygen supply line to the side. Actually, it is unclear at which point of this blade the oxygen supply line should end to facilitate the best possible oxygen supply for apneic oxygenation.
In this simulation study using a standardized human airway manikin, the efficacy of apneic oxygenation by oxygen insufflation using standard and modified Macintosh blades was compared: a standard Macintosh blade without oxygen supply line as control, one with an additional oxygen supply line ending proximal near the handle, one with the line ending at the middle of the blade, and one with the line ending near the tip. A preoxygenated test lung was connected to an oximeter with a flow rate of 200ml/min, simulating oxygen consumption of a male adult, and to the trachea of an anatomically correctly shaped airway manikin. Apneic oxygenation was performed and oxygen content was measured over a 20-minutes observation period. Experiments were repeated five times for each
laryngoscope blade.
Oxygen percentage in the test lung dropped from 100 ± 0% at the start of the experiment to 53 ± 1.5% in the room air control group (p < 0.001 compared to all other groups), and to 74 ± 2.5% in the proximal oxygen line group, whereas oxygen percentage remained at 100% in both the medium and distal oxygen line groups (p = 1 between these groups; p < 0.001 between all other groups).
In this simulation study with a preoxygenated airway manikin, the use of a modified Macintosh
laryngoscope blade with oxygen line attached at the tip or at the middle were able to maintain apneic oxygenation without measurable drop of oxygen content over 20 min. Proximal placement of the oxygen supply line still showed an advantage against room air, however it did not completely prevent room air from entering the airway.
Not applicable.