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Comparison of Cardiac Output and Hemodynamic Responses of Intubation among Different Videolaryngoscopies in Normotensive and Hypertensive Patients

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2015年第3期35卷 432-438页

作者： amro faez abdelgawad 石琴芳 Mohamed AboHalawa 吴志林武宙阳陈向东姚尚龙 Department of Anesthesiology Union Hospital Tongji Medical College Huazhong University of Science and Technology Department of Anesthesiology Faculty of Medicine Benha UniversityEgypt Department of Anesthesiology Faculty of Medicine Suez Canal University

Tracheal intubation with Macintosh laryngoscope（MAC） might result in severe cardiovascular complications. The results of conducted studies investigating the effects of videolaryngoscopies on hemodynamic response of tracheal intubation are conflicting. We know little about the effects of videolaryngoscopies on cardiac output changes during tracheal intubation. We compared cardiac output（COP） and hemodynamic responses in normal blood pressure（n=60） and hypertensive patients（n=60） among 3 intubation devices： the MAC, the UE videolaryngoscopy ？（UE）, and the UE video intubation stylet ？（VS）. Cardiac index（CI）, stroke volume index（SVI）, heart rate（HR）, systolic blood pressure（SBP） and diastolic blood pressure（DBP） were recorded using Lidco Rapid V2？ preinduction, preintubation, and every minute for the first 5 min after intubation. We assessed oropharyngeal and laryngeal structures injury as well. Intubation time was significantly shorter than MAC groups（P〈0.001） only in UE group of normotensive and hypertensive patients. In normotensive patients, there were no significant differences in any of COP variables or hemodynamic variables among the three devices. In hypertensive patients, SBP and DBP in the MAC group were significantly higher（P〈0.05 or 〈0.01） than the UE and VS groups at 1, 2 and 3 min after intubation, but there were no significant differences in CI, SVI and HR among the three devices. There was no significant difference in oropharyngeal and laryngeal structures injury among all groups. It was concluded that both the UE and VS attenuate only the hemodynamic response to intubation as compared with the MAC in hypertensive patients, but not in normotensive patients.

关键词： arterial pressure response laryngoscopy tracheal intubation cardiac output

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