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使用机械通气的气管切开患者气管误吸的发生率。

Incidence of tracheal aspiration in tracheotomized patients in use of mechanical ventilation.

作者信息

Simão Mariana de Almeida, Alacid Camila Albuquerque Nobre, Rodrigues Katia Alonso, Albuquerque Christiane, Furkim Ana Maria

机构信息

Qualifono - Serviços em Fonoaudiologia, Rio de Janeiro, RJ, Brasil.

出版信息

Arq Gastroenterol. 2009 Oct-Dec;46(4):311-4. doi: 10.1590/s0004-28032009000400012.

DOI:10.1590/s0004-28032009000400012
PMID:20232012
Abstract

CONTEXT

Many patients in use of mechanical ventilation show clinical complications due to tracheal aspiration. Assessment and early methods are necessary, so that preventive and safety measures apply to this patients.

OBJECTIVE

To study the incidence of tracheal aspiration of saliva in tracheotomized patients treated in intensive care unit using two modes of mechanical ventilation and with different sedation levels.

METHOD

Prospective study with 14 tracheotomized non-neurological patients using mechanical ventilation. The sample was divided into two groups based on ventilation mode: pressure support ventilation and pressure controlled ventilation. Those two groups were subdivided into two others according to sedation level. The speech pathology evaluation was completed via the blue dye test in order to analyze the incidence of tracheal aspiration of saliva.

RESULTS

Sedation levels and mechanical ventilation time related to tracheal aspiration were not statistically significant in this study. On the other hand, ventilation mode and tracheal aspiration showed statistical significance, and there was a higher incidence of tracheal aspiration in the pressure controlled ventilation mode.

CONCLUSION

It was possible to observe a significant relationship between tracheal aspiration incidence and pressure controlled ventilation mode, which means the inclusion of those patients in the risk group for oropharyngeal dysphagia and their insertion in prevention protocols. The relationship between tracheal aspiration and sedation level, as well as tracheal aspiration and mechanical ventilation, were not statistically significant in this sample, needing further research.

摘要

背景

许多使用机械通气的患者因气管误吸出现临床并发症。评估和早期方法是必要的,以便对这些患者采取预防和安全措施。

目的

研究在重症监护病房接受治疗的气管切开患者中,使用两种机械通气模式并处于不同镇静水平时唾液气管误吸的发生率。

方法

对14例使用机械通气的非神经科气管切开患者进行前瞻性研究。样本根据通气模式分为两组:压力支持通气和压力控制通气。这两组再根据镇静水平细分为另外两组。通过蓝色染料试验完成言语病理学评估,以分析唾液气管误吸的发生率。

结果

在本研究中,与气管误吸相关的镇静水平和机械通气时间无统计学意义。另一方面,通气模式与气管误吸具有统计学意义,压力控制通气模式下气管误吸的发生率更高。

结论

可以观察到气管误吸发生率与压力控制通气模式之间存在显著关系,这意味着应将这些患者纳入口咽吞咽困难风险组,并将其纳入预防方案。在该样本中,气管误吸与镇静水平以及气管误吸与机械通气之间的关系无统计学意义,需要进一步研究。

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