期刊论文详细信息
BMC Anesthesiology
A systematic review of the role of videolaryngoscopy in successful orotracheal intubation
David W Healy1  Oana Maties1  David Hovord1  Sachin Kheterpal1 
[1] Department of Anesthesiology, University of Michigan Hospital, 1500 East Medical Center Drive 1H247, Box 0048, Ann Arbor, Michigan 48109, USA
关键词: Technology;    Intubation;    Airway management;    Laryngoscopy;   
Others  :  816954
DOI  :  10.1186/1471-2253-12-32
 received in 2012-05-10, accepted in 2012-11-29,  发布年份 2012
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【 摘 要 】

Background

The purpose of our study was to organize the literature regarding the efficacy of modern videolaryngoscopes in oral endotracheal intubation, then perform a quality assessment according to recommended external criteria and make recommendations for use.

Methods

Inclusion criteria included devices with recent studies of human subjects. A total of 980 articles were returned in the initial search and 65 additional items were identified using cited references. After exclusion of articles failing to meet study criteria, 77 articles remained. Data were extracted according to the rate of successful intubation and improvement of glottic view compared with direct laryngoscopy. Studies were classified according to whether they primarily examined subjects with normal airways, possessing risk factors for difficult direct laryngoscopy, or following difficult or failed direct laryngoscopy.

Results

The evidence of efficacy for videolaryngoscopy in the difficult airway is limited. What evidence exists is both randomized prospective and observational in nature, requiring a scheme that evaluates both forms and allows recommendations to be made.

Conclusions

In patients at higher risk of difficult laryngoscopy we recommend the use of the Airtraq, CTrach, GlideScope, Pentax AWS and V-MAC to achieve successful intubation. In difficult direct laryngoscopy (C&L >/= 3) we cautiously recommend the use of the Airtraq, Bonfils, Bullard, CTrach, GlideScope, and Pentax AWS, by an operator with reasonable prior experience, to achieve successful intubation when used in accordance with the ASA practice guidelines for management of the difficult airway. There is additional evidence to support the use of the Airtraq, Bonfils, CTrach, GlideScope, McGrath, and Pentax AWS following failed intubation via direct laryngoscopy to achieve successful intubation. Future investigation would benefit from precise qualification of the subjects under study, and an improvement in overall methodology to include randomization and blinding.

【 授权许可】

   
2012 Healy et al.; licensee BioMed Central Ltd.

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