smpСкорая медицинская помощьEMERGENCY MEDICAL CARE2072-6716Northwest State Medical University named after II Mechnikov10.24884/2072-6716-2020-21-3-33-38smp-429Research ArticleСТАТЬИARTICLESОПЫТ ПРОВЕДЕНИЯ ВИДЕОЛАРИНГОСКОПИИ ПРИ ИНТУБАЦИИ ТРАХЕИ ПО ЭКСТРЕННЫМ ПОКАЗАНИЯМ В ПРАКТИКЕ ВРАЧА-АНЕСТЕЗИОЛОГА И РЕАНИМАТОЛОГАEXPERIENCE OF VIDEO LARYNGOSCOPY DURING TRACHEAL INTUBATION FOR EMERGENCY INDICATIONS IN THE PRACTICE OF AN ANESTHESIOLOGIST AND RESUSCITATORВасильевВ. В.VasilevV. V.

Васильев Владимир Васильевич - кандидат медицинских наук, доцент кафедры скорой и неотложной помощи

129110, Москва, ул. Щепкина, д. 61/2, корп. 1

confader@yandex.ruМосковский областной научно-исследовательский клинический институт им. М. Ф. ВладимирскогоРоссияMoscow Regional Research Clinical Institute named after M. F. VladimirskyRussian Federation2020141020202133338Copyright © Васильев В.В., 20202020Васильев В.В.Vasilev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://smp.spb.ru/jour/article/view/429Цель

Цель: определить преимущества и недостатки видеоларингоскопии как одного из методов интубации трахеи, который все чаще используется в работе анестезиолога как альтернатива прямой ларингоскопии.

Материалы и методы исследования. Вместе с рутинным использованием прямой ларингоскопии было выполнено более 100 интубаций трахеи с использованием видеоларингоскопа. Из них сделан анализ 48 интубаций. В настоящей статье описаны 4 клинических случая. Результаты исследования. При видеоларингоскопии визуализация за Cormack-Lehane I наблюдалась в 39 (81,3%), Cormack-Lehane II - у 9 больных (18,8%). Интубация с первой попытки была в 43 случаях (89,6%), со второй попытки — в 4 (8,3%). У одного больного интубация была неудачной (2,1%). Среднее время успешной попытки интубации составило 36,9 с. Трудности наблюдались во время интубации трахеи при продвижении эндотрахеальной трубки. В этой статье приведены практические рекомендации по особенностям проведения интубации при возникновении технических сложностей.

Выводы

Выводы. Видеоларингоскопия - это безопасный и эффективный метод интубации трахеи. Имея ряд преимуществ, таких как улучшение визуализации трахеи, этот метод не лишен недостатков. Мы считаем, что этот метод стоит рассматривать не как полную замену прямой ларингоскопии, а как вспомогательный в случаях тяжелой интубации трахеи.

Objectives

Objectives. To assess the advantages and disadvantages of videolaryngoscopy as one of methods of tracheal intubation which is being widely used as an alternative to direct laryngoscopy in anesthesiologist’s practice.

Material and methods

Material and methods. Over 100 of tracheal intubations were conducted with the use of videolaryngoscope, along with a routine use of the direct laryngoscopy. The results of 48 intubations are discussed. 4 clinical cases are presented in this article.

Results

Results. Cormack-Lehane grade I view was obtained in 39 cases (81,3%), Cormack-Lehane grade II - in 9 patients (18,8%). First attempt intubation was performed in 43 cases (89,6%), in 4 cases intubation was successful after second attempt (8,3%), failed intubation was in 1 case (2,1%). The mean duration of successful intubation was 36,9 sec. Certain difficulties occured during intubation related with the advancement of the endotracheal tube. Technical solutions are given for some of intraprocedural conditions.

Conclusions

Conclusions. Videolaryngoscopy is a safe and effective method of tracheal intubation. Although this method is not lacking in disadvantages it has a number of advantages, main of which is the improved larynx visualization. In our opinion, this method can not completely replace direct laryngoscopy in anesthesiolodist’s practice, but may serve as an adjuvant in case of difficult intubation.

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The authors declare that there are no conflicts of interest present.