解剖学和生理学上困难的气道在国家紧急气道登记册中的第一次尝试成功
Dhimitri A Nikolla1, Joseph Offenbacher2, Silas W Smith2,3
1From the Department of Emergency Medicine, Allegheny Health Network - Saint Vincent Hospital, Erie, Pennsylvania.
Anesthesia and analgesia
|February 9, 2024
概括
解剖学上困难的呼吸道 (ADA) 显著降低了急诊室首次试图的气管管道输入成功. 生理上困难的气道 (PDA) 单独没有影响成功率,但与ADA结合,它们在没有不良事件的情况下降低了成功率.
科学领域:
- 紧急医疗 紧急医疗
- 麻醉学 麻醉学
- 关键的护理关键的护理
背景情况:
- 在急诊室 (ED) 中,某些呼吸道特征可能会增加气管管道输液并发症.
- 解剖学上困难的呼吸道 (ADA) 和生理上困难的呼吸道 (PDA) 可能会对输入管的结果产生负面影响.
研究的目的:
- 调查预期困难的气道 (ADA,PDA,或两者) 和首次试图在ED中成功进行气管管道输入的关系.
- 为了比较患者与没有困难的气道特征之间的第一次尝试成功率.
主要方法:
- 从2016年至2018年使用国家紧急航道登记处 (NEAR) 进行的回顾性观察研究.
- 包括成人ED输管与镇静和麻,不包括心脏骤停患者.
- 分析了第一次尝试的成功,没有不良事件的成功,以及使用混合效应模型的其他结果.
主要成果:
- 单独的ADA与较低的第一次尝试成功率有关 (aOR为0.53).
- 单单PDA就没有显示出第一次尝试成功的显著差异 (aOR 0.96).
- 联合的ADA和PDA显著降低了第一次尝试的成功率 (aOR 0.44) 和没有不良事件的成功率 (aOR 0.44).
结论:
- 在ED中,ADA与首次气管管道输入成功相反相关.
- 单独使用PDA并没有显著影响第一次尝试的成功.
- 单独和组合的ADA和PDA都与没有不良事件的成功输管率较低有关.
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