超角视频喉腔镜对气管管道输管的第一次尝试成功的影响:系统性审查和元分析
Rafael von Hellmann1, Julia M Dorn de Carvalho2, Ashwin Subramaniam3
1Department of Intensive Care Medicine, Monash Health, Victoria, Australia.
The American journal of emergency medicine
|September 12, 2025
概括
超角视频喉腔镜 (HAVL) 与标准几何视频喉腔镜 (SGVL) 相比,在紧急输管中显示出较低的首次成功率和增加的呼吸道创伤. 建议SGVL用于紧急气道管理.
科学领域:
- 麻醉学 麻醉学
- 紧急医疗 紧急医疗
- 航空航道管理的管理.
背景情况:
- 视频喉腔镜 (VLS) 对于口腔管道输入至关重要.
- 超角VLS (HAVL) 旨在改善喉视图和输管成功.
- 需要与标准几何VLS (SGVL) 进行比较,特别是在紧急情况下.
研究的目的:
- 为了比较HAVL与SGVL在成年人口腔管道输入术的首次尝试成功率 (FAS).
- 评估HAVL在紧急气道管理中的安全性和有效性.
主要方法:
- 随机对照试验和比较观察研究的系统审查和元分析.
- 在主要数据库 (MEDLINE,Embase,Cochrane,Scopus,Web of Science) 进行的搜索截至2024年11月.
- 使用既有工具评估的偏见风险和证据确定性 (RoB2,纽卡斯尔-太华,GRADE).
主要成果:
- 包括25项研究 (38,597名患者);HAVL显示整体FAS较低 (87.2%对91.0%).
- 在紧急输管时,HAVL产生了减少FAS (RR 0.97) 和增加呼吸道创伤 (7.5%对2.9%).
- 难以呼吸道没有显著差异;由于偏差和异质性,证据的确定性较低.
结论:
- 与SGVL相比,HAVL与较低的第一次尝试成功率和增加的呼吸道创伤在紧急输入管道中有关.
- 支持优先考虑SGVL应急气道管理.
- 如果使用HAVL,操作员培训至关重要.
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