Abad Gurumeta A, Calvo Vecino J M, San Norberto García L, Muñoz Avalos N, Pérez Gallardo A, Gilsanz Rodríguez F
Servicio de Anestesiología, Hospital General Universitario Gregorio Marañón, Madrid.
Rev Esp Anestesiol Reanim. 2008 Jan;55(1):4-12. doi: 10.1016/s0034-9356(08)70491-2.
In the monitoring of anesthesia, airway pressure is measured in the ventilator or at the closest possible connection to the endotracheal tube.
To compare the airway pressures and pressure-volume loops obtained before connection to the endotracheal tube with those obtained in the trachea.
We carried out a single-blind prospective observational study on ASA 1 patients between the ages of 7 and 12 years ventilated in volume-control mode with an inspiration-to-expiration ratio of 1:2. Intratracheal and extratracheal peak and plateau pressures and pressure-volume loops were recorded. A special device was designed to monitor intratracheal pressure. Both sensors were connected to the same spirometric analysis system. The variables were measured on intubation and 5, 10, 15, 20, 30, 40, 50, and 60 minutes after intubation. The recorded pressures were compared using the t test, the Pearson product moment correlation coefficient (r), and the Spearman rank correlation coefficient (p), and regression models were fit to the data.
Seventy-one patients were enrolled. The mean (SD) pressure difference between the 2 systems was 3.5 (0.35) cm H2O (P < .01) and no differences between the endotracheal peak pressures and the plateau pressures were observed. The intratracheal areas of the pressure-volume loops were 15% lower than the extratracheal areas. The value of r for the correlation between the intratracheal peak and plateau pressures was 0.998 (P < .01). The value of r for the correlation between the intratracheal and extratracheal peak pressures was 0.981 (P < .01). Analysis of variance confirmed the linear relationship.
The difference between the intratracheal and extratracheal pressure measurements is due to the different locations at which the measurements are taken.
在麻醉监测中，气道压力在呼吸机或与气管内导管尽可能靠近的连接处进行测量。
比较连接气管内导管前与气管内所获得的气道压力和压力-容积环。
我们对年龄在7至12岁、采用容量控制模式通气且吸呼比为1:2的ASA 1级患者进行了一项单盲前瞻性观察研究。记录气管内和气管外的峰值及平台压力以及压力-容积环。设计了一种特殊装置来监测气管内压力。两个传感器均连接至同一肺量分析系统。在插管时以及插管后5、10、15、20、30、40、50和60分钟测量变量。使用t检验、Pearson积矩相关系数（r）和Spearman秩相关系数（p）比较记录的压力，并对数据拟合回归模型。
纳入71例患者。两个系统之间的平均（标准差）压力差为3.5（0.35）cm H₂O（P <.01），未观察到气管内峰值压力与平台压力之间存在差异。压力-容积环的气管内面积比气管外面积低15%。气管内峰值与平台压力之间的相关r值为0.998（P <.01）。气管内与气管外峰值压力之间的相关r值为0.981（P <.01）。方差分析证实了线性关系。
气管内和气管外压力测量值之间的差异是由于测量位置不同所致。
