POREĐENJE McGRATH VIDEO-LARINGOSKOPA I MACINTOSH LARINGOSKOPA U ENDOTRAHEALNOJ INTUBACIJI HIRURŠKIH PACIJENATA BEZ PREDIKTORA OTEŽANOG DISAJNOG PUTA
Sažetak
U ovom istraživanju smo analizirali i upoređivali efikasnost upotrebe McGrath video-laringoskopa i Macintosh laringoskopa u endotrahealnoj intubaciji pacijenata bez prediktora otežanog disajnog puta koji se podvrgavaju elektivnim hirurškim procedurama.
Istraživanje je obuhvatilo šezdeset pacijenata, koji su podeljeni u dve grupe sačinjene od trideset pacijenata: McGrath (MC) grupu i Macintosh (MAC) grupu. Glavni cilj istraživanja bilo je poređenje trajanja intubacije i vizuelizacije glotisa na osnovu Cormack–Lehane (CL) skale. Sporedni cilj bilo je poređenje trajanja laringoskopije, procenta uspešnih intubacija iz prvog pokušaja, broja pokušaja intubacije, neželjenih događaja (trauma tkiva, desaturacija < 90%, lomljenje zuba), broja neuspešnih intubacija, BURP (engl. Backward, Upward, Rightward Pressure – BURP) manevara i upotreba bužija.
Rezultati su pokazali značajno češći CL gradus I u MG grupi nego u MAC grupi (80% prema 40%; p = 0,004). Trajanje laringoskopije bilo je značajno kraće u MG grupi nego u MAC grupi (7,87 ± 1,70 prema 6,00 ± 0,95; p < 0,001). Međutim, nije bilo statistički značajne razlike u trajanju intubacije između grupa (26,03 s ± 1,32 s prema 28,30 s ± 5,66 s u MG grupi i MAC grupi; p = 0,057). Iz prvog pokušaja uspešno je intubirano 96,7% pacijenata u MG grupi i 86,7% pacijenata u MAC grupi (p = 0,350). BURP manevar bio je značajno češći u MAC grupi (p = 0,024) u toku laringoskopije. Nisu zabeležene značajne razlike među grupama kada je reč o komplikacijama.
Kod pacijenta bez prediktora otežanog disajnog puta koji se podvrgavaju elektivnim hirurškim procedurama McGrath video-laringoskop značajno poboljšava vizuelizaciju glotisa, skraćuje trajanje laringoskopije i smanjuje potrebu za izvođenjem BURP manevra. Ne postoji značajna razlika u trajanju intubacije, stopi uspešnih intubacija iz prvog pokušaja i komplikacija prilikom korišćenja McGrath video-laringoskopa i Macintosh laringoskopa.
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