在急诊室使用直接喉腔镜进行快速序列输入的患者中,床上抬头的位置与仰卧的嗅觉位置 - 随机对照试验
Admala Anudeep Reddy1, S Manu Ayyan1, D Anandhi1
1Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Journal of emergencies, trauma, and shock
|July 29, 2024
概括
床上抬头 (BUHE) 位置没有改善输管时间或第一次通道成功率,与快速顺序输管 (RSI) 期间的卧卧嗅位置 (SSP) 相比. 然而,BUHE显示,输管后并发症略有减少.
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:
- 快速序列输管 (RSI) 是紧急医学的关键程序.
- 在RSI期间优化患者的定位对于成功的内内管注射至关重要.
- 卧式嗅探姿势 (SSP) 是一种传统的方法,而床上抬头姿势 (BUHE) 是一种较新的替代方法.
研究的目的:
- 为了比较BUHE位置与SSP在急诊室 (ED) 中RSI期间直接喉镜的疗效.
- 评估患者定位对输管时间,首次通道成功率和输管后并发症的影响.
主要方法:
- 一个单中心,随机控制的优越性试验,涉及136名在学术ED中接受RSI的患者.
- 患者被随机分配到BUHE位置或SSP.
- 主要结局:进入内内管道输入的时间. 二次结果:第一次通过成功率和输管后并发症.
主要成果:
- 在BUHE和SSP之间输管时间没有显著差异 (32.09s与33.40s,P=0.17).
- 类似的第一次通过成功率 (91.18%对90.91%,P=0.958).
- 当BUHE组的专家进行输管时,观察到输管时间的适度减少 (P=0.04).
- 与SSP相比,BUHE组的输液后并发症较少 (7.4%与19.7%,P=0.04).
结论:
- 在经历RSI的ED患者中,BUHE位置与SSP相比没有改善输管时间或第一通成功率.
- 在BUHE位置下,观察到输液后并发症的轻微减少.
- 专家的表现可能会给BUHE带来适度的输管时间缩短.
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