Endotracheal intubation in patients with COVID-19 using an ultrathin flexible gastrointestinal endoscope

• 作者: Chizuko Yamada Shigenori Masaki Takashi Kawamoto
• 来源期刊: 世界胃肠内镜杂志:英文版(电子版)
• 学科: 医学
• 关键词: Endotracheal intubation SARS-CoV-2 COVID-19 LARYNGOSCOPES BRONCHOSCOPES Gastrointestinal endoscopes
• 年，卷（期）: 2020,（10）
• 页码范围: 404-407
• 页数: 4页
• 分类号: R37

摘要

Pneumonia caused by severe acute respiratory syndrome coronavirus 2 occasionally becomes severe and requires endotracheal intubation.Endotracheal intubation is usually performed using a laryngoscope;however,the operator needs to be in close proximity to the patient’s face during the procedure,which increases the risk of droplet exposure.Therefore,we simulated fiberoptic endotracheal intubation on a mannequin representing the patient,using an ultrathin flexible gastrointestinal endoscope as an alternative to the bronchoscope,in order to maintain distance from the patient during the procedure.We performed this procedure 10 times and measured the time required;the median procedure time was 6.4 s(interquartile range,5.7-8.1 s).The advantage of this method is the short procedure time and distance maintained from the patients.The flexible tip-steerable control and length of the gastrointestinal endoscope contributed to shortening the procedure time and maintaining distance from the patients.In addition,this method can handle difficult airways without risk of misplacement of the endotracheal tube.However,it is necessary to consider the risk of aerosol generation associated with this procedure.In the pandemic setting of coronavirus disease 2019,this approach may be useful when a gastrointestinal endoscopist is in charge of endotracheal intubation of patients with coronavirus disease 2019.