模拟急诊婴儿口咽污染期间的器械性能：气道解剖结构与液体稠度的影响。

文献信息

中文摘要

背景： 儿科口咽部突然被反流物、呕吐物或血液污染是一种时间紧迫的气道急症。可能需要快速清除以恢复喉部视野并允许通气和气管插管。在解剖受限的婴儿气道中，常用吸引器械的比较数据仍然有限。我们评估了气道解剖结构和液体稠度如何影响硬质Yankauer吸引头与14 French（Fr）柔性吸引导管的性能。
方法： 这项初步模拟研究使用了两个互补模型：一个解剖受限的婴儿气道模型和一个无约束的开放容器模型。水、全脂牛奶和原味酸奶（50 mL）代表稠度递增的污染物。两种器械均在标准化的壁式吸引压力-200 mmHg下测试，该压力被选为高真空急诊台架条件，而非常规儿科吸引的推荐压力。在模型中，测量了吸引时间、咽部排出量、咽部/食管残余量和回收肺容积。在容器模型中，记录了完全排空的时间。
结果： 在婴儿气道模型中，Yankauer对三种液体的咽部排出量均更大。Yankauer对水的吸引时间更短，但对牛奶或酸奶无显著差异。酸奶污染后，Yankauer的咽部/食管残余量更大，而两种器械之间的回收肺容积无显著差异。在无约束模型中，Yankauer更快地排出水和牛奶，并清除了所有酸奶样本；14 Fr导管在任何试验中均未能在五分钟限制内完全排空酸奶。
结论： 在本模拟的标准高真空条件下，相对器械性能在两个实验模型之间以及不同稠度的液体之间存在差异。Yankauer提供了更大的批量清除，而柔性导管在解剖受限模型中留下的酸奶残余更少。这些台架发现并未确立任一器械在推荐儿科吸引压力下的安全性或临床优越性，并支持在较低压力和模拟喉镜检查期间进行进一步评估。

英文摘要

Background: Sudden contamination of the pediatric oropharynx by regurgitated material, emesis, or blood is a time-critical airway emergency. Rapid clearance may be required to restore laryngeal visualization and permit ventilation and tracheal intubation. Comparative data for commonly available suction devices in anatomically constrained infant airways remain limited. We evaluated how airway anatomy and fluid consistency affect the performance of a rigid Yankauer suction tip and a 14 French (Fr) flexible suction catheter. Methods: This pilot simulation study used two complementary models: an anatomically constrained infant airway mannequin and an unconstrained open-container model. Water, whole milk, and plain yogurt (50 mL) represented contaminants of increasing consistency. Both devices were tested at a standardized wall-suction pressure of -200 mmHg, selected as a high-vacuum emergency bench condition rather than as a recommended pressure for routine pediatric suctioning. In the mannequin, suction time, evacuated pharyngeal volume, residual pharyngeal/esophageal volume, and recovered lung volume were measured. In the container model, time to complete evacuation was recorded. Results: In the infant airway mannequin, the Yankauer evacuated greater pharyngeal volumes for all three fluids. Suction time was shorter with the Yankauer for water but did not differ significantly for milk or yogurt. After yogurt contamination, residual pharyngeal/esophageal volume was greater with the Yankauer, while recovered lung volumes did not differ significantly between devices. In the unconstrained model, the Yankauer evacuated water and milk more rapidly and cleared all yogurt samples; the 14 Fr catheter did not completely evacuate yogurt within the five-minute limit in any trial. Conclusions: Under the standardized high-vacuum conditions of this simulation, relative device performance differed between the two experimental models and across fluids of differing consistency. The Yankauer provided greater bulk removal, whereas the flexible catheter left less residual yogurt in the anatomically constrained model. These bench findings do not establish the safety or clinical superiority of either device at recommended pediatric suction pressures and support further evaluation at lower pressures and during simulated laryngoscopy.