【原】【罂粟摘要】喉导管在心肺复苏期间气道管理中的作用

喉导管在心肺复苏期间气道管理中的作用

贵州医科大学　高鸿教授课题组

翻译：陈锐　编辑：佟睿　审校：曹莹

背景

突发心脏骤停是欧洲和全世界的病人死亡的主要原因之一。有效的胸部按压和先进的气道管理已被证明可以提高存活率。声门上气道装置，如喉管(LT)，是基础生命支持(BLS)和高级生命支持(ALS)期间心脏骤停患者的一种常用的的抢救策略。本系统文献综述旨在总结当前在实施BLS和ALS时使用LT的数据。

证据搜集

通过使用Medline数据库和特定的搜索策略，收集了有关在心肺复苏(CPR)过程中使用LT的最新数据。术语的使用顺序和组合各不相同，没有时间限制。共由两名经验丰富的麻醉医生/急诊医生独立鉴定和筛选了N=1005项研究。总共确定了N=19篇相关文献的数据并纳入分析。

证据分析

与初始气道管理的其他策略(2.2% vs 1.4%)相比，使用LT显示快速、简便的置入方式具有高成功率(76% vs 94%)，并与较高的短期存活率(2.2% vs 1.4%)相关。心肺复苏的质量，如胸腔压缩分数(CCF)在置入胸腔前后得到改善(75% vs 59%)。对于长期存活率，LT显示较低的存活率。

结论

特别是作为气道管理的初始设备(对于经验不足的工作人员)，使用LT操作简单，插入速度快，与袋式口罩通气和气管插管相比，LT的优点在最近的文献中是不均匀的。

英文摘要 Abstract

Performance of the laryngeal tube for airway  management during cardiopulmonary resuscitation

INTRODUCTION: sudden cardiac arrest is one of the leading causes of death in europe and the whole world. effective chest compressions and advanced airway management have been shown to improve survival rates. supraglottic airway

devices such as the laryngeal tube (LT) are a well-known strategy for patients with cardiac arrest during both basic (BLS) and advanced life support (ALS). this systematic literature review aimed to summarize current data for using the lt when performing BLS and ALS.

EVIDENCE ACQUISITION: recent data on the use of the lt during cardiopulmonary resusation (CPR) was gathered by using the Medline database and a specific search strategy. Terms were used in various order and combinations without time restrictions. A total of N.=1005 studies were identified and screened by two experienced anesthesiologists/emer-gency physicians independently. Altogether, data of N.=19 relevant papers were identified and included in the analysis.

EVIDENCE SYNTHESIS: Using the lt showed fast and easy placement with high success rates (76% to 94%) and was associated with higher hort-term survival as compared to other strategies for initial airway management (2.2% vs. 1.4%). Quality of CPR such as chest compression fraction (ccF) before and after lt-insertion is improved (75% vs. 59%). For long-term survival, the lt showed lower survival rates.

CONCLUSIONS: especially as initial device of airway management (for inexperienced staff), the use of a lt is easy and results in a fast insertion. the advantages of the lt as compared to bag mask ventilation and endotracheal intubation are inhomogeneous in recent literature.

(Cite this article as: Hinkelbein J, schmitz J, Mathes a, De robertis e. Performance of the laryngeal tube for airway manage-ment during cardiopulmonary resuscitation. Minerva Anestesiol 2021;87:580-90. 

DOI: 10.23736/S0375-9393.20.14446-8)

Key words: cardiopulmonary resuscitation; airway management; critical care.

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