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在儿科患者中使用间接和直接喉镜进行气管输管的血液动力学反应:系统性审查和网络元分析
Risa Takeuchi1, Hiroshi Hoshijima2, Masanori Tsukamoto3
1Bunkoukai Special Needs Dental Clinic, 2765-5 Ujiie, Sakura 329-1311, Japan.
Children (Basel, Switzerland)
|June 26, 2025
概括
在儿童患者的气管输管治疗期间,Airtraq喉镜在预防血液动力学变化方面最有效,例如心率 (HR) 和平均血压 (MBP) 的增加. 这种网络元分析将Airtraq排名为最大,因为它尽量减少了这些不良的血液动力学反应.
科学领域:
- 麻醉学 麻醉学
- 儿科重症监护 儿科重症监护
- 医疗器械技术 医疗器械技术
背景情况:
- 气管输管可以引起显著的血液动力学反应,包括心率 (HR) 和血压 (BP) 的升高,对儿科患者构成风险.
- 在输管过程中尽量减少这些不良的血液动力学事件对于患者的安全和结果至关重要.
研究的目的:
- 进行网络元分析 (NMA),根据其在儿科患者气管输管治疗期间管理血液动力学反应 (HR和平均血压,MBP) 的有效性,对间接和直接喉腔镜进行排名.
- 为了确定最好抑制HR和MBP在输入管后增加的喉镜装置.
主要方法:
- 包括16项前性随机试验,比较儿科患者中使用间接和直接喉腔镜进行气管输入的血液动力学反应.
- 使用随机效应模型进行元分析,计算HR和MBP的加权平均差异 (WMD) 和95%置信区间 (CI).
- 雇佣的P-scores来自网络估计,以排名输内管装置,还分析输内管时间作为相关因素.
主要成果:
- 与麦金托什喉镜相比,Airtraq喉镜显著抑制了HR (WMD = -16.7) 和MBP (WMD = -8.57) 的增加.
- 在HR和MBP方面,Airtraq获得了最高的P-score排名,这表明血液动力学稳定性优越.
- 对于HR和输管时间的顶级设备包括Airtraq,Coopdech视频喉镜,米勒,C-MAC和Wis-Hipple.
结论:
- 网络元分析提供了一个强大的排名的输内管装置,以减轻小儿气管输内管道的血液动力学变化.
- 艾特拉克喉镜被认为是预防儿科气管输管过程中不良血液动力学反应的最佳设备.
- 此外,Airtraq还在评估的设备中表现出最短的输管时间.
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