Bernet V, Dullenkopf A, Maino P, Weiss M
Department of Neonatology and Intensive Care Medicine, University Children's Hospital Zurich, Switzerland.
Anaesthesia. 2005 Nov;60(11):1123-8. doi: 10.1111/j.1365-2044.2005.04359.x.
Cuffed tracheal tubes are becoming increasingly popular in paediatric anaesthesia and intensive care medicine. To avoid cuff related complications and airway morbidity, a thorough understanding of cuff volume/pressure behaviour and management is required. In this study, the outer cuff diameter and form stability of the cuff at high cuff pressure were assessed in a series of different paediatric cuffed tracheal tubes with internal diameter of between 3.0 and 5.0 mm. The main findings were that small amounts of inflated air led to a rapid increase in cuff pressure and volume and that the outer cuff diameters increased to 2-2.5 times the age-corresponding internal tracheal diameter following inadvertent syringe inflation. Careful cuff inflation under cuff pressure monitoring and/or automatic cuff pressure release is recommended in paediatric tracheal tube cuffs to prevent airway damage caused by manual inflation, pilot balloon compression and nitrous oxide diffusion.
带套囊的气管导管在小儿麻醉和重症医学中越来越普遍。为避免与套囊相关的并发症和气道发病情况，需要全面了解套囊容积/压力行为及管理方法。在本研究中，对一系列内径在3.0至5.0毫米之间的不同小儿带套囊气管导管，评估了套囊外径以及高套囊压力下套囊的形状稳定性。主要发现是，少量充气会导致套囊压力和容积迅速增加，且在意外通过注射器充气后，套囊外径增加到与年龄相应的气管内径的2至2.5倍。建议在小儿气管导管套囊中进行套囊压力监测和/或自动释放套囊压力的情况下谨慎充气，以防止手动充气、控制囊压迫和氧化亚氮扩散造成气道损伤。
