Ding L-W, Wang H-C, Wu H-D, Chang C-J, Yang P-C
Dept of Internal Medicine, National Taiwan University Hospital, Chung-Shan South Road, Taipei 100, Taiwan.
Eur Respir J. 2006 Feb;27(2):384-9. doi: 10.1183/09031936.06.00029605.
The cuff-leak test was widely used for the prediction of post-extubation stridor, but controversial results limit its clinical application. The current study used real-time ultrasonography to evaluate the air-leak and hypothesised that the air-column width, measured by ultrasonography, may be correlated to the development of post-extubation stridor. From June 1, 2001 to March 1, 2002, a total of 51 planned extubations in 51 consecutively intubated patients were included. All of the patients received ultrasonographical examinations of their vocal cords and larynx in addition to an air-column width measurement within 24 h prior to extubation. The overall post-extubation stridor rate was 7.8%. The air-leak volume presented as median (interquartile range) were 300 (350) mL and 25 (20) mL, respectively, for the nonstridor and stridor groups. The air-column width during cuff deflation was 6.4 (2) mm and 4.5 (0.8) mm, respectively. They were found to be statistically significant. In conclusion, the authors demonstrated that laryngeal ultrasonography could be a reliable, noninvasive method, in the evaluation of vocal cords, laryngeal morphology and the ease of airflow, which passed through vocal cords or subglottic area due to laryngeal oedema. The air-column width during cuff deflation was a potential predictor of post-extubation stridor.
套囊漏气试验广泛用于预测拔管后喘鸣，但结果存在争议限制了其临床应用。本研究采用实时超声评估漏气情况，并假设超声测量的气柱宽度可能与拔管后喘鸣的发生相关。2001年6月1日至2002年3月1日，共纳入51例连续插管患者的51次计划拔管。所有患者在拔管前24小时内除了测量气柱宽度外，还接受了声带和喉部的超声检查。总体拔管后喘鸣发生率为7.8%。非喘鸣组和喘鸣组的漏气量中位数（四分位间距）分别为300（350）mL和25（20）mL。套囊放气时的气柱宽度分别为6.4（2）mm和4.5（0.8）mm。发现它们具有统计学意义。总之，作者证明了喉部超声检查在评估声带、喉部形态以及因喉水肿导致气流通过声带或声门下区域的通畅程度方面，可能是一种可靠的非侵入性方法。套囊放气时的气柱宽度是拔管后喘鸣的一个潜在预测指标。
