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

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences Vol. 35; no. 3; pp. 432 - 438
• Main Authors: Abdelgawad, Amro Faez, Shi, Qin-fang, Halawa, Mohamed Abo, Wu, Zhi-lin, Wu, Zhou-yang, Chen, Xiang-dong, Yao, Shang-long
• Format: Journal Article
• Language: English
• Published: Wuhan Huazhong University of Science and Technology 01.06.2015; Department of Anesthesiology, Faculty of Medicine, Benha University, Egypt%Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China%Department of Anesthesiology, Faculty of Medicine, Suez Canal University, Egypt; Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
• Subjects: Adult; Aged; Blood Pressure - physiology; Cardiac Output - physiology; Female; Hemodynamics; Humans; Hypertension - physiopathology; Hypertension - surgery; Intubation, Intratracheal - instrumentation; Intubation, Intratracheal - methods; Laryngoscopy - instrumentation; Laryngoscopy - methods; Larynx - anatomy & histology; Larynx - injuries; MAC; Macintosh; Male; Medicine; Medicine & Public Health; Middle Aged; Oropharynx - anatomy & histology; Oropharynx - injuries; Video-Assisted Surgery - methods; Young Adult; 动力学反应; 心输出量; 气管插管; 结构损伤; 血流; 高血压患者; cardiac output; laryngoscopy; arterial pressure; tracheal intubation; response
• ISSN: 1672-0733; 1993-1352
• DOI: 10.1007/s11596-015-1449-7

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.