吸出量と吸入量の比率を測定することによって,内圧の調節
Kelly Moon1, Sibelle Aurelie Yemele Kitio1, Julie Rice-Weimer1
1Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
Paediatric anaesthesia
|September 6, 2025
まとめ
呼吸とインスピレーションの潮流量比 (TVe/TVi) を調整することで,小児患者の内側管 (ETT) のマッチング圧を効果的に調節します. 0.9または0.8の比率は,高圧を防止し,ETTの使用に関連するリスクを軽減します.
科学分野:
- 麻酔科
- 小児重症室
- 呼吸器の生理学
背景:
- エンドトラケア管 (ETT) のマッシュアップ圧力が高くなると (20~30cmH2O以上) 重篤な気管合併症が発生する可能性があります.
- カフットの圧力を管理する従来の方法は,常に最適なレベルを維持できないかもしれません.
研究 の 目的:
- ETT内圧を調節するために,吐出と吸入の潮量 (TVe/TVi) の比率を用いた新しい技術を評価する.
- TVe/TVi調整の効果と,安全なマッチング圧力を維持する継続的な陽性空気圧 (CPAP) を比較する.
主な方法:
- ETTで全身麻酔を受けている50人の小児患者を対象とした前向きなクロスオーバー試験です.
- TVe/TVi比を1. 0と0. 9と0. 8に調整して,空気抜きで圧力を測定した.
- カフプレッシャー管理のためのベースラインCPAP方法との比較
主要な成果:
- 発症時のCPAPでは10人の患者さんのマニュアル圧力は30cmH2O以上でした.
- TVe/ TVi比が1. 0であったとき,2人の患者は30cmH2Oを超えた.
- TVe/TVi比は0.9と0.8で,マッシュプレッシャーが30cmH2O以上で,圧力はそれぞれ8.9cmH2Oと8.2cmH2Oに低下した例はありません.
結論:
- TVe/TViの調整は,CPAPと比較して,ETT圧力を制御するためのより効果的な方法を提供します.
- TVe/TVi比のテクニックは,特に0.9または0.8で,カフの圧力が望ましい安全な範囲内に留まり,陽性性のリスクを軽減します.
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