Vergleich von Fertigsets zur Koniotomie

Abstract

This study allowed the comparison of surgical coniotomy to several ready-to-use devices in a standardized setting utilizing a reusable plastic mannequin. The interpretation for real emergency conditions is limited as individual anatomy, traumatic alterations of the neck or complications, such as bleeding or damage of important structures were not part of the study objectives. However, all participating emergency physicians successfully used the coniotomy sets provided at the first attempt. No device required significantly more time than the surgical approach. The procedures using cuffed devices lasted longer in comparison to procedures using uncuffed ones; however, this difference would only play a minor role in reality as effective ventilation with minute volumes greater than 7 l/min will only be achieved by a cuffed cannula with a minimum internal diameter of 4 mm. Devices with no cuff or with tube diameters smaller than 4 mm will only allow oxygenation of the patient, which in turn requires an inspiratory oxygen concentration of 100% and a relatively high ventilation frequency.

Emergency cricothyrotomy – a systematic review

“…A total of 108 full text articles were retrieved, and two authors read them independently; 24 studies were included in this review (Figure 1) [21,22,24,25,29-48]. The 85 studies that were excluded in this process did not include sufficient information on comparison between two or more techniques to be included in this review.…”

“…We have identified the following comparisons between two such kits: Airf vs. PCK, QT1, QT2 and Trqu, respectively; PCK vs. QT1, QT2 and Trqu, respectively; QT1 vs. QT2 and Trqu, respectively; as well as Pati vs. QT1 and QT2 vs. Trqu [29,32,42]. No significant difference in success rate was observed in any of the comparisons.…”

“…A variety of the surgical technique has been compared to Airf, Pert, PCK, QT1, QT2 and Trqu [25,29,32-34,36,47,48]. In one study, Csci and QT1 has been compared [25].…”

“…Need has been compared to Airf, PCK, QT1, QT2 and Trqu, while Trac has been compared to Pati and QT2 [29,42]. In none of the comparisons, a significant difference in success rate was found.…”

“…Only three studies directly compared one open surgical technique with a needle technique and no significant difference in the success rates between the two methods was detected [29,33,43]. …”