喉管evo在心脏骤停期间通气中球囊面罩通气与容量控制通气的比较——一项在人体遗体供者中开展的前瞻性随机研究
Comparison of bag-valve-device ventilation and volume-controlled ventilation with laryngeal tube evo in intra-arrest ventilation-a prospective randomized study in human body donors.
文献信息
| PMID | 42786506 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Cornelius Christopher Falk |
| 作者单位 | Ruhr University Bochum, Medical Faculty of Ruhr University Bochum, Universitätstraße 150, Bochum, 44801, Germany. cornelius.falk@edu.ruhr-uni-bochum.de. |
| 期刊 | Journal of anesthesia, analgesia and critical care |
| SCI 分区 | Q1 |
| IF | 4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 本研究评估了新型声门上气道装置喉管evo在机械胸外按压期间心脏骤停通气治疗中对目标通气参数的影响，比较球囊面罩通气与容量控制通气。
方法： 将经Thiel法防腐处理的人体遗体供者纳入标准化复苏场景。在机械心肺复苏期间，采用随机顺序使用喉管evo进行球囊面罩通气和容量控制通气。记录呼气潮气量（Vte）及每公斤体重呼气潮气量（Vte/kgBW）、潮气量差值（理想潮气量与呼气潮气量之差；ΔVt）、漏气量（Vleak）、峰值压（Ppeak）、平均压（Pmean）和平台压（Pplat）以及呼吸频率。主要疗效终点为Vte。
结果： 共纳入5具遗体供者。尽管1具供者（20%）在所有通气模式下均成功通气，但3具仅能在其中一种模式下通气（球囊面罩通气=20%；容量控制通气=40%）。1具供者（20%）在任何模式下均无法充分通气。球囊面罩通气的平均Vte为91.73±66.3 ml，而容量控制通气为142.93±115.05 ml。两种通气模式的比较显示，容量控制通气的Vte更高（50.27 ml；95%置信区间（CI）：7.56至92.97；p=0.02）、Vte/kgBW更高（0.8 ml；95% CI：0.05至1.56；p=0.04）、Pmean更高（5.23 mbar；95% CI：4至6.47；p<0.0001）和Pplat更高（10.36 mbar；95% CI：8.08至12.64；p<0.0001），但ΔVt更低（-50.3 ml；95% CI：-93至-7.59；p=0.02）且呼吸频率更低（-10.83/分；95% CI：-17.29至-4.36；p=0.001）。
结论： 在使用喉管evo进行机械心肺复苏期间的非同步通气中，与球囊面罩通气相比，容量控制通气导致更高的Vte和Vte/kgBW，但ΔVt和呼吸频率更低。未来研究应评估喉管evo在机械心肺复苏期间院前使用的情况。当对其有效性存在疑虑时，应进行同步通气（30:2）。
试验注册： 德国临床试验注册中心；唯一标识符：DRKS00037836。注册日期：2025年9月9日[1]。
英文摘要
BACKGROUND: This study evaluated the effects of the new supraglottic airway device known as laryngeal tube evo on target parameters of ventilation therapy during mechanical chest compressions in intra-arrest ventilation with bag-valve-device ventilation vs. volume-controlled ventilation.
METHODS: Thiel-embalmed human body donors were included in a standardized resuscitation scenario. Ventilation was performed in a randomized order using the laryngeal tube evo for bag-valve-device ventilation and volume-controlled ventilation during mechanical cardiopulmonary resuscitation. Expiratory (Vte) and expiratory tidal volumes per kg body weight (Vte/kgBW); delta tidal volume (difference between ideal and expiratory tidal volume; ΔVt); leakage volume (Vleak); peak (Ppeak); mean (Pmean) and plateau (Pplat) pressures and respiratory rates were recorded. The primary efficacy endpoint was Vte.
RESULTS: Five body donors were included. Although one donor (20%) was successfully ventilated with all ventilation modes, three could only be ventilated with one of the modes (bag-valve-device ventilation = 20%; volume-controlled ventilation = 40%). One donor (20%) could not be sufficiently ventilated with any of the modes. Mean Vte was 91.73 ± 66.3 ml with bag-valve-device ventilation versus 142.93 ± 115.05 ml with volume-controlled ventilation. The comparison of both ventilation modes revealed higher Vte (50.27 ml; 95% confidence interval (CI): 7.56 to 92.97; p = 0.02), Vte/kgBW (0.8 ml; 95% CI: 0.05 to 1.56; p = 0.04), Pmean (5.23 mbar; 95% CI: 4 to 6.47; p < 0.0001) and Pplat (10.36 mbar; 95% CI: 8.08 to 12.64; p < 0.0001), but lower ∆Vt (- 50.3 ml; 95% CI: - 93 to - 7.59; p = 0.02) and respiratory rates (- 10.83/min; 95% CI: - 17.29 to - 4.36; p = 0.001) for volume-controlled ventilation.
CONCLUSIONS: Comparing volume-controlled ventilation with bag-valve-device ventilation for asynchronous ventilation during mechanical cardiopulmonary resuscitation using the laryngeal tube evo, volume-controlled ventilation resulted in higher Vte and Vte/kgBW, but lower ∆Vt and respiratory rates. Future studies should evaluate laryngeal tube evo in prehospital use during mechanical cardiopulmonary resuscitation. When doubts regarding its effectiveness are present, synchronous ventilation (30:2) should be performed.
TRIAL REGISTRATION: German Clinical Trials Register; unique identifier: DRKS00037836. Registered on September 09, 2025 [1].