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输内管袖口压力评估:预期与现实对比
Valentyn Sadovyi1, Iurii Kuchyn2, Kateryna Bielka2,3
1University Clinic of Bogomolets National Medical University, Kyiv, Ukraine.
Anaesthesiology intensive therapy
|February 7, 2025
概括
充气内管袖口的最小泄漏技术在维持安全压力方面比触摸更有效,降低了麻醉期间气管损伤的风险.
科学领域:
- 麻醉学 麻醉学
- 密集护理医学 密集护理医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 气管损伤虽然很少发生,但在麻醉学和重症监护中是一个重要的风险.
- 这种损伤的主要原因是机械的,源于内管 (ETT) 袖口内的过度压力.
- 了解和控制ETT袖口压力对于患者安全至关重要.
研究的目的:
- 为了评估手术过程中实际的袖口压力.
- 为了将测量的压力与麻醉师的主观评估相关联.
- 为了比较不同ETT袖口膨胀方法的有效性.
主要方法:
- 90名患者被随机分为两组:研究 (最小泄漏技术) 和控制 (触摸).
- 在两组中,ETT袖口压力都使用机械气压计进行测量.
- 最少的泄漏技术涉及膨胀袖口,直到检测到最小的空气泄漏.
主要成果:
- 研究小组使用最小泄漏技术,达到平均袖口压力为30.4±4.9cmH2O.
- 对照组,依靠触摸,平均袖口压力明显高,为68.9±23.3cmH2O.
- 在对照组中,只有4.4%的患者的血压处于安全范围 (20-30cmH2O),而在研究组中为51.1%.
结论:
- 触摸是一种不充分的方法来确定适当的ETT袖口压力.
- 最小泄漏技术是控制ETT袖口压力的更可靠方法.
- 这种技术有助于保持压力在推的安全范围内,减轻气管损伤风险.
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