Farré R, Rotger M, Ferre M, Torres A, Navajas D
Unitat de Biofisica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona, Spain.
Eur Respir J. 2002 Oct;20(4):1010-3. doi: 10.1183/09031936.02.02692001.
To avoid tracheal wall damage or inadvertent falls of the endotracheal tube cuff pressure (Pcuff) in intubated and mechanically-ventilated patients, the authors devised a simple procedure for automatic and continuous regulation of Pcuff. The procedure, only requiring a simple aquarium air pump and conventional tubing, was first tested at the bench when applied to an intubated and ventilated lung model, including an artificial trachea with an externally-variable section. The clinical performance of the procedure was tested in eight intubated patients, in whom the endotracheal tube cuff was connected to the designed Pcuff regulator during 24 h. The bench test showed that the procedure was able to maintain Pcuff constant, regardless of the changes imposed in the tracheal section. It was also effective in maintaining Pcuff during routine mechanical ventilation. Actual Pcuff recorded over the 24-h period always coincided with the target value within +/-2 cmH2O in all the patients. The procedure devised to maintain endotracheal tube cuff pressure is readily implemented, cheap, easy to operate and can be used regardless of the specific ventilator or tube used. Routine implementation of this procedure may be useful for protecting the trachea from tissue damage and for reducing the risk of ventilator-associated pneumonia.
为避免气管插管并机械通气患者出现气管壁损伤或气管内导管套囊压力（Pcuff）意外下降，作者设计了一种用于自动持续调节Pcuff的简单方法。该方法仅需一个简单的水族箱气泵和常规管道，首先在实验台上应用于气管插管并通气的肺模型进行测试，该模型包括一个具有外部可变截面的人工气管。该方法的临床性能在8例气管插管患者中进行了测试，在这些患者中，气管内导管套囊在24小时内连接到设计的Pcuff调节器上。实验台测试表明，无论气管截面如何变化，该方法都能使Pcuff保持恒定。在常规机械通气期间，它也能有效维持Pcuff。在所有患者中，24小时内记录的实际Pcuff始终与目标值在+/-2 cmH2O范围内相符。所设计的维持气管内导管套囊压力的方法易于实施、成本低廉、操作简便，且无论使用何种特定呼吸机或导管均可使用。常规实施该方法可能有助于保护气管免受组织损伤，并降低呼吸机相关性肺炎的风险。
