儿童麻醉中视频喉镜检查的可用性和实践模式以及呼吸暂停氧合的适应性:儿科麻醉医师的横断面调查。

IF 1.7 4区 医学 Q2 ANESTHESIOLOGY
Pediatric Anesthesia Pub Date : 2025-06-01 Epub Date: 2025-02-05 DOI:10.1111/pan.15079
Wenyu Bai, Prabhat Koppera, Yuan Yuan, Graciela Mentz, Bridget Pearce, Megan Therrian, Paul Reynolds, Sydney E S Brown
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引用次数: 0

摘要

背景:视频喉镜检查(VL)和窒息氧合被强烈推荐并越来越多地用于儿科麻醉实践;然而,VL的可得性、在推荐的临床环境(如新生儿、气道急诊和手术室外气管插管)中的使用,以及VL的可得性与儿科麻醉师如何定义插管困难的关系尚未探讨。方法:对几个国际儿科麻醉学会的成员进行电子调查,以检查VL的可用性和实践模式,并探讨在VL背景下确定儿童气管插管困难的标准。结果:总有效率为12.9%。据报道,VL在主要儿科手术室和非现场手术室“最有可能提供”的比例分别为93%和80.1%。57%的参与者在预期气管插管困难时会首先选择VL;在这种情况下,近30%的受访者会选择直接喉镜检查,VL作为备用。三分之一的受试者会选择VL作为非手术室(non-OR)紧急气管插管和早产儿或新生儿的首选,而不管插管的预期困难。30%的受试者报告在困难喉镜检查时使用了呼吸暂停氧合。机构VL可用性与提供者如何定义困难气管插管无关。结论:VL是高度可用的,但根据儿科麻醉学会最近的建议,VL和呼吸暂停氧合用于治疗困难的气管插管的采用低于预期。插管困难的定义存在异质性,这可能导致患者安全风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Availability and Practice Patterns of Videolaryngoscopy and Adaptation of Apneic Oxygenation in Pediatric Anesthesia: A Cross-Sectional Survey of Pediatric Anesthesiologists.

Background: Videolaryngoscopy (VL) and apneic oxygenation are highly recommended and increasingly used in pediatric anesthesia practice; yet, availability, use in recommended clinical settings (e.g., neonates, airway emergencies, and out-of-operating-room tracheal intubation), and the association of VL availability with how pediatric anesthesiologists define difficult intubation have not been explored.

Method: An electronic survey was distributed to the members of several international pediatric anesthesia societies to examine the availability and practice patterns of VL and to explore the criteria used to define a difficult tracheal intubation in children in the context of VL.

Results: The response rate was 12.9%. VL was reported to be "most likely available" in main pediatric operating rooms and offsite locations 93% and 80.1% of the time, respectively. Fifty-seven percent of participants would select VL first when anticipating a difficult tracheal intubation; nearly 30% of respondents would choose direct laryngoscopy first and VL as a backup in this scenario. One-third of subjects would select VL as their first choice for nonoperating room (non-OR) emergency tracheal intubation and for premature or newborn infants, regardless of anticipated difficulty with intubation. Thirty percent of subjects reported using apneic oxygenation during difficult laryngoscopy. Institutional VL availability was not associated with how providers defined difficult tracheal intubation.

Conclusion: VL is highly available, but the adoption of VL and apneic oxygenation for managing difficult tracheal intubation was lower than expected, given recent recommendations by pediatric anesthesia societies. There was heterogeneity in how difficult intubation was defined, resulting in a possible patient safety risk.

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来源期刊
Pediatric Anesthesia
Pediatric Anesthesia 医学-麻醉学
CiteScore
3.20
自引率
11.80%
发文量
222
审稿时长
3-8 weeks
期刊介绍: Devoted to the dissemination of research of interest and importance to practising anesthetists everywhere, the scientific and clinical content of Pediatric Anesthesia covers a wide selection of medical disciplines in all areas relevant to paediatric anaesthesia, pain management and peri-operative medicine. The International Editorial Board is supported by the Editorial Advisory Board and a team of Senior Advisors, to ensure that the journal is publishing the best work from the front line of research in the field. The journal publishes high-quality, relevant scientific and clinical research papers, reviews, commentaries, pro-con debates, historical vignettes, correspondence, case presentations and book reviews.
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