喉膜口罩呼吸道的三种充气方法的有效性和安全性Ambu® AuraonceTM:一项随机对照研究
Teresa Prim1, Nicolas Brogly2, Emilia Guasch2
1Department of Anesthesiology and Reanimation Surgical Intensive Care, Hospital Universitario La Paz /Cantoblanco/Carlos III, Madrid, Spain. TERESA.PRIM@SALUD.MADRID.ORG.
Journal of clinical monitoring and computing
|August 4, 2023
概括
对于在支气管镜检查期间使用喉膜口罩的气道,将AuraOnceTM LMA袖口充满一半最大体积 (MV) 有效地控制袖口内压力. 这种方法提供了一个安全的替代品,当压力计不可用时,不影响通风或增加并发症.
科学领域:
- 麻醉学 麻醉学
- 呼吸系统医学 呼吸系统医学
- 医疗器械 医疗器械
背景情况:
- 喉膜呼吸道 (LMA) 对于呼吸道管理至关重要.
- 在LMA中,袖口过膨胀会导致呼吸不良和胃不通气等并发症.
- 优化LMA袖口膨胀对于手术期间的患者安全至关重要.
研究的目的:
- 为了确定AuraOnceTM LMA在Endobronchial超声波支气管镜检查 (EBUS) 期间的最佳袖口膨胀方法.
- 为了比较三个不同的袖口充气技术的有效性和安全性:剩余体积 (RV),最大体积的一半 (MV) 和不变体积 (NV).
主要方法:
- 进行了一项随机对照的双盲临床试验,包括210名接受EBUS的患者.
- 根据LMA袖口膨胀方法 (RV,MV,NV) 将患者随机分为三个组.
- 评估的关键参数包括手套内压力 (IP),气道泄漏压力 (OLP),泄漏体积 (LV) 和术后并发症 (PC).
主要成果:
- 平均手套内压力 (IP) 在各组之间有显著差异,MV组的压力较低 (59.4厘米H2O),相比RV (75.1厘米H2O) 和NV (83.1厘米H2O) (P <0.01).
- 在MV组中,IP>60厘米H2O的发病率明显较低 (30.8%),而不是RV (68.1%) 和NV (71.6%) (P<0.01).
- 在组之间没有观察到插入成功率,OLP,LV或PC的显著差异.
结论:
- 对于AuraOnceTM LMA袖口的半最大体积 (MV) 膨胀方法,可以有效控制袖口内压力.
- 这种技术是管理LMA袖口膨胀的可行选择,特别是在没有压力计时.
- 该方法提供足够的气道密封,而不会增加术后并发症的风险.
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