在急诊室使用上呼吸道超声波测量来预测困难的喉腔镜/困难的输管病例:一项前性观察性研究
Mehran Sotoodehnia1, Maryam Khodayar2, Alireza Jalali3,4
1Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
BMC emergency medicine
|July 25, 2023
概括
超声波可以预测困难的喉腔镜和急诊患者的输内管道. 特定的超声波测量,如从皮肤到下垂体骨的距离 (DSHB),从皮肤到声带的距离 (DSVC) 和从皮肤到甲状腺缺口的距离 (DSTI) 显示出显著的相关性.
科学领域:
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
- 医疗成像医学成像
背景情况:
- 困难的喉腔镜和输管术对急诊室 (ED) 中的重症患者构成重大风险.
- 需要一种快速,准确和非侵入性的方法来预测这些具有挑战性的气道管理场景.
- 上呼吸道超声波已经成为评估呼吸道的潜在工具.
研究的目的:
- 为了研究特定的上呼吸道超声波参数与ED患者难以进行喉腔镜检查或难以输入管道的发生之间的相关性.
- 评估超声波测量对于具有挑战性的呼吸道程序的预测价值.
主要方法:
- 一项前性观察性研究,包括需要快速序列输管 (RSI) 的成年患者.
- 测量的超声波参数:下垂体骨可见度 (HBV),从皮肤到下垂体骨的距离 (DSHB),从皮肤到声带的距离 (DSVC),从皮肤到甲状腺缺口的距离 (DSTI) 和甲状腺软骨之间的距离 (DBAC).
- 难以进行的喉腔镜术定义为Cormack-Lehane等级III/IV;难以进行的输内管道是>3次尝试. 数据与超声波测量相比较.
主要成果:
- 在困难的喉腔镜和DSHB (p=0.002),DSVC (p=0.003) 和DSTI (p=0.001) 之间发现了显著的相关性.
- 在难以输管和HBV (p=0.004),DSVC (p=0.025) 和DSTI (p=0.001) 之间发现了显著的相关性.
- DBAC与难以进行喉腔镜检查或输管检查没有显著的相关性.
结论:
- 超声波参数DSHB,DSVC和DSTI是ED患者难以进行喉腔镜的潜在预测指标.
- HBV,DSVC和DSTI可能是难以输管的预测因素.
- 在这种情况下,DBAC不是预测困难的气道管理的可靠参数.
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