{"id":20783,"date":"2022-01-05T04:51:00","date_gmt":"2022-01-04T20:51:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=20783"},"modified":"2022-01-05T05:32:29","modified_gmt":"2022-01-04T21:32:29","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87-%e4%bd%bf%e7%94%a8%e6%8e%a2%e6%9d%a1bougie%e6%88%96%e5%b8%a6%e6%9c%89%e7%ae%a1%e8%8a%afstylet%e7%9a%84%e6%8f%92%e7%ae%a1%e5%af%b9%e5%8d%b1%e9%87%8d","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=20783","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]: \u4f7f\u7528\u63a2\u6761(Bougie)\u6216\u5e26\u6709\u7ba1\u82af(Stylet)\u7684\u63d2\u7ba1\u5bf9\u5371\u91cd\u75c5\u60a3\u8005\u6c14\u7ba1\u63d2\u7ba1\u9996\u6b21\u6210\u529f\u7387\u7684\u5f71\u54cd"},"content":{"rendered":"\n

Original Investigation Caring for the Critically Ill PatientDecember 8, 2021<\/p>\n\n\n\n

Effect of Use of a Bougie vs Endotracheal Tube With Stylet on Successful Intubation on the First Attempt Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial<\/h1>\n\n\n\n

Brian E.\u00a0Driver,\u00a0Matthew W.\u00a0Semler,\u00a0Wesley H.\u00a0Self,\u00a0et al<\/h3>\n\n\n\n

JAMA.\u00a0<\/em>Published online December 8, 2021. doi:10.1001\/jama.2021.22002<\/h3>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  For critically ill adults undergoing emergency tracheal intubation, failure to intubate the trachea on the first attempt occurs in up to 20% of cases and is associated with severe hypoxemia and cardiac arrest. Whether using a tracheal tube introducer (\u201cbougie\u201d) increases the likelihood of successful intubation compared with using an endotracheal tube with stylet remains uncertain.<\/p>\n\n\n\n

Objective<\/strong>  To determine the effect of use of a bougie vs an endotracheal tube with stylet on successful intubation on the first attempt.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  The Bougie or Stylet in Patients Undergoing Intubation Emergently (BOUGIE) trial was a multicenter, randomized clinical trial among 1102 critically ill adults undergoing tracheal intubation in 7 emergency departments and 8 intensive care units in the US between April 29, 2019, and February 14, 2021; the date of final follow-up was March 14, 2021.<\/p>\n\n\n\n

Interventions<\/strong>  Patients were randomly assigned to use of a bougie (n\u2009=\u2009556) or use of an endotracheal tube with stylet (n\u2009=\u2009546).<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was successful intubation on the first attempt. The secondary outcome was the incidence of severe hypoxemia, defined as a peripheral oxygen saturation less than 80%.<\/p>\n\n\n\n

Results<\/strong>  Among 1106 patients randomized, 1102 (99.6%) completed the trial and were included in the primary analysis (median age, 58 years; 41.0% women). Successful intubation on the first attempt occurred in 447 patients (80.4%) in the bougie group and 453 patients (83.0%) in the stylet group (absolute risk difference, \u22122.6 percentage points [95% CI, \u22127.3 to 2.2]; P<\/em>\u2009=\u2009.27). A total of 58 patients (11.0%) in the bougie group experienced severe hypoxemia, compared with 46 patients (8.8%) in the stylet group (absolute risk difference, 2.2 percentage points [95% CI, \u22121.6 to 6.0]). Esophageal intubation occurred in 4 patients (0.7%) in the bougie group and 5 patients (0.9%) in the stylet group, pneumothorax was present after intubation in 14 patients (2.5%) in the bougie group and 15 patients (2.7%) in the stylet group, and injury to oral, glottic, or thoracic structures occurred in 0 patients in the bougie group and 3 patients (0.5%) in the stylet group.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Among critically ill adults undergoing tracheal intubation, use of a bougie did not significantly increase the incidence of successful intubation on the first attempt compared with use of an endotracheal tube with stylet.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT03928925<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation Caring for the Critically I […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20783"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20783"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20783\/revisions"}],"predecessor-version":[{"id":20784,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20783\/revisions\/20784"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20783"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20783"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20783"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}