研究使用Evac气管导管抽吸声门下分泌物失败的情况。
Investigating the failure to aspirate subglottic secretions with the Evac endotracheal tube.
作者信息
Dragoumanis Christos K, Vretzakis George I, Papaioannou Vassilios E, Didilis Vassilios N, Vogiatzaki Theodsia D, Pneumatikos Ioannis A
机构信息
Department of Intensive Care, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
出版信息
Anesth Analg. 2007 Oct;105(4):1083-5, table of contents. doi: 10.1213/01.ane.0000278155.19911.67.
BACKGROUND
Aspiration of subglottic secretions is a widely used intervention for prevention of ventilator-associated pneumonia. However, using the Hi-Lo Evac endotracheal tube (Hi-Lo Evac; Mallinckrodt; Athlone, Ireland) (Evac ETT), dysfunction of the suction lumen and subsequent failure to aspirate the subglottic secretions are common. Our objective in this study was to determine the causes of suction lumen dysfunction experienced with the Evac ETT.
METHODS
We studied 40 adult patients intubated with the Evac ETT. In all cases for which dysfunction of the suction lumen was observed, the subglottic suction port was examined visually using a flexible bronchoscope.
RESULTS
Dysfunction of the suction lumen occurred in 19 of 40 patients (48%). In 17 of these (43%), it was attributed to blockage of the subglottic suction port by suctioned tracheal mucosa.
CONCLUSION
Evacuation of subglottic secretions using the Evac ETT is often ineffective due to prolapse of tracheal mucosa into the subglottic suction port.
背景
声门下分泌物吸引是预防呼吸机相关性肺炎广泛采用的干预措施。然而，使用高低压可撤离气管内导管（Hi-Lo Evac气管内导管；Mallinckrodt公司；爱尔兰阿斯隆）（可撤离气管内导管）时，吸引腔功能障碍及随后无法吸出声门下分泌物的情况很常见。本研究的目的是确定可撤离气管内导管出现吸引腔功能障碍的原因。
方法
我们研究了40例使用可撤离气管内导管进行插管的成年患者。在所有观察到吸引腔功能障碍的病例中，使用可弯曲支气管镜对声门下吸引口进行了直视检查。
结果
40例患者中有19例（48%）出现吸引腔功能障碍。其中17例（43%）是由于被吸引的气管黏膜堵塞声门下吸引口所致。
结论
由于气管黏膜脱垂至声门下吸引口，使用可撤离气管内导管进行声门下分泌物吸引往往无效。
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