Weiss Markus, Gerber Andreas C
Universität Zürich.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2012 Apr;47(4):232-7. doi: 10.1055/s-0032-1310411. Epub 2012 Apr 13.
In the last 5 years the use of cuffed tracheal tubes in infants and children has become popular worldwide and is accepted by major medical authorities. The advantages of cuffed tracheal tubes in smaller children - in particular the almost 100% chance to insert the right sized tracheal tube at the first attempt and their reliable sealing characteristics within the trachea - makes tracheal intubation and ventilation considerable easier and safer. This certainly compensates for the higher cost of cuffed compared to uncuffed tracheal tubes. The fear that cuffed tracheal tubes cause increased laryngeal damage in small children could not be confirmed, if adequately designed, cuffed tracheal tubes are correctly used. Conditions for the safe use of cuffed tubes in children are the availability of an adequately designed cuffed tube with a proofed recommendation for tube size selection and cuff pressure monitoring. The following rules must be fulfiled when cuffed tubes in children using are: confirmation of an air leak < 20 cmH2O inspiratory pressure with the cuff not inflated, cuff pressure limitation at 20 cmH2O and the avoidance of negative cuff pressures, resulting in sharp, cutting edges of the cuff membrane within the trachea.
在过去5年里，带套囊气管导管在婴幼儿中的使用在全球范围内变得流行起来，并被主要医学权威机构所接受。带套囊气管导管对于较小儿童的优势——特别是几乎有100%的机会在首次尝试时插入尺寸合适的气管导管，以及它们在气管内可靠的密封特性——使得气管插管和通气变得相当容易和安全。这无疑弥补了带套囊气管导管相比无套囊气管导管更高的成本。如果设计得当且正确使用，担心带套囊气管导管会对小儿喉部造成更大损伤的顾虑是无法得到证实的。在儿童中安全使用带套囊导管的条件是要有设计得当的带套囊导管，并附有经证实的导管尺寸选择和套囊压力监测建议。在儿童使用带套囊导管时必须遵循以下规则：在套囊未充气时确认吸气压力<20 cmH₂O时有漏气，将套囊压力限制在20 cmH₂O，并避免出现负压套囊压力，以免套囊膜在气管内形成尖锐的切割边缘。
