Godoy Armando Carlos Franco de, Vieira Ronan José, Capitani Eduardo Mello De
Emergency Department Ward, University Hospital, State University at Campinas - School of Medicine, Campinas, Brazil.
J Bras Pneumol. 2008 May;34(5):294-7. doi: 10.1590/s1806-37132008000500008.
The purpose of this study was to investigate endotracheal tube cuff pressure (Pcuff) alteration in patients under mechanical ventilation after changes in position.
All selected patients were initially placed in the 35 degrees semi-Fowler position, with Pcuff adjusted to 20 mmHg, and randomly divided into two groups. Group A, in which patients were moved to the lateral decubitus position, facing away from the ventilator (measurement designated Pcuff A1), returned to the initial position (measurement designated Pcuff A2), moved to a lateral decubitus position, facing the ventilator (measurement designated Pcuff A3) and then returned to the initial position (measurement designated Pcuff A4); and Group B, in which patients were moved to the lateral decubitus position, facing the ventilator (measurement designated Pcuff B1), returned to the initial position (measurement designated Pcuff B2), moved to the lateral decubitus position; facing away from the ventilator (measurement designated Pcuff B3) and then returned to the initial position (measurement designated Pcuff B4).
The study comprised 70 patients, 31 allocated to group A and 39 allocated to group B. Values >22 mmHg were observed in 142(50.7%) of the 280 Pcuff measurements taken, and values <18 mmHg were observed in 14 (5%). When moved from the 35 degrees semi-Fowler position to the lateral decubitus position, facing away from the ventilator, 58 (82.2%) of the patients presented mean Pcuff values in the higher range (>22 mmHg).
Changes in body position can cause significant Pcuff variations in patients under mechanical ventilation.
本研究旨在调查机械通气患者在体位改变后气管导管套囊压力（Pcuff）的变化。
所有入选患者最初置于35度半卧位，将Pcuff调整至20 mmHg，并随机分为两组。A组患者先转向背向呼吸机的侧卧位（测量值记为Pcuff A1），再回到初始体位（测量值记为Pcuff A2），然后转向面向呼吸机的侧卧位（测量值记为Pcuff A3），最后回到初始体位（测量值记为Pcuff A4）；B组患者先转向面向呼吸机的侧卧位（测量值记为Pcuff B1），再回到初始体位（测量值记为Pcuff B2），然后转向背向呼吸机的侧卧位（测量值记为Pcuff B3），最后回到初始体位（测量值记为Pcuff B4）。
本研究共纳入70例患者，A组31例，B组39例。在280次Pcuff测量中，有142次（50.7%）测量值>22 mmHg，14次（5%）测量值<18 mmHg。当从35度半卧位转向背向呼吸机的侧卧位时，58例（82.2%）患者的平均Pcuff值处于较高范围（>22 mmHg）。
体位改变可导致机械通气患者的Pcuff发生显著变化。
