婴儿三指握法与三指握法加新发明的下额手法的面罩通气质量比较：双盲随机对照试验

IF 0.4 4区医学 Q4 PEDIATRICS

Iranian Journal of Pediatrics Pub Date : 2023-11-18 DOI:10.5812/ijp-139732

M. Goudarzi, A. Maleki, Hassan Radmehr, Alireza Ebrahim Soltani, Elahe Radmehr

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引用次数: 0

摘要

背景：面罩通气是管理和维持患者气道的最重要环节之一。良好的面罩通气可避免插管。研究目的本研究旨在比较两种不同的婴儿面罩固定技术的通气质量：三指握持法和三指握持法加新开发的舌下操作法。方法：这项双盲随机对照试验包括在德黑兰儿童医疗中心接受全身吸入麻醉择期手术的 90 名 1 岁以下婴儿。每名患者都被随机分配到其中一个干预组，在插管前使用其中一种面罩固定技术进行全身麻醉。收集了每位患者的人口统计学数据。使用 Drager 仪器对过量潮气量（VTE）进行定量评估，然后根据呼吸流量质量分为良好（5 - 7 mL/kg）、一般（3 - 5 mL/kg）和不良（< 3 mL/kg）三组。结果：在这项研究中，与三指握持法相比，在统计意义上，下额法的 VTE 明显更好。三指握法组分别有 30 名、15 名和 0 名患者记录到良好、一般和较差的质量，而下颌手法组分别有 39 名、6 名和 0 名患者记录到良好、一般和较差的质量（P = 0.025）。我们将患者按体重指数（BMI）分为四组，分别为 10 - 14、15 - 19、20 - 24 和 25 - 29，并比较了每组中两种技术之间的 VTE 差异。结果表明，在体重指数为 20 - 24 的组别中，在统计学上，下颌手法的气流质量明显更好（P = 0.047）。结论在三指握持法的基础上增加下额法，似乎能提高婴儿的呼气潮气量。此外，对于体重指数（BMI）较高和下颌软组织较大的儿童，下颌手法似乎比三指握持法能提供更好的通气质量。

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Comparison of Facemask Ventilation Quality Between the Three-Finger Grip and the Three-Finger Grip Plus the Newly-Devised Submental Maneuver in Infants: A Double-Blind, Randomized Controlled Trial

Background: Mask ventilation is one of the most important aspects of managing and maintaining a patient's airway. Performing good mask ventilation can avoid the need for intubation. Objectives: This study aimed to compare the ventilation quality of two different mask-holding techniques in infants: The three-finger grip and the three-finger grip plus the newly-devised submental maneuver. Methods: This double-blind, randomized controlled trial included 90 infants under 1 year of age undergoing elective surgery under general inhalation anesthesia in Tehran Children's Medical Center. Each patient was randomly allocated to one of the interventional groups, and general anesthesia was induced using one of the mask-holding techniques before intubation. Demographic data for each patient was collected. Expired tidal volume (VTE) was assessed quantitatively by the Drager machine and then classified into three groups of quality of breath flow as either good (5 - 7 mL/kg), fair (3 - 5 mL/kg), or bad (< 3 mL/kg). Results: In this study, VTE was shown to be statistically significantly better in the submental maneuver compared with the three-finger grip. Good, fair, and bad qualities were recorded for 30, 15, and 0 patients in the three-finger grip group and 39, 6, and 0 patients in the submental maneuver group, respectively (P = 0.025). Classifying patients into four groups of body mass index (BMI), 10 - 14, 15 - 19, 20 - 24, and 25 - 29, we compared VTE between the two techniques within each group. The results showed that in the BMI group of 20 - 24, the quality of breath flow was statistically significantly better in the submental maneuver (P = 0.047). Conclusions: Adding the submental maneuver to the three-finger grip seems to provide better expired tidal volume in infants. Also, it seems that in children with higher BMI and larger submental soft tissue, the submental maneuver provides better ventilation quality than the three-finger grip.

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来源期刊

Iranian Journal of Pediatrics 医学-小儿科

CiteScore

0.90

自引率

20.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.