Huang Ling, Xie Chen, Zhang Lifeng, Meng Liying, Li Guizheng, Li Yang, Huang Bing, Pan Linghui, Tang Zhanhong
Department of Critical Care Medicine, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China (Huang L, Zhang LF, Meng LY, Li GZ, Li Y, Huang B, Pan LH); Medtronic (Shanghai) Management Co., Ltd, Shanghai 201203, China (Xie C); Department of Critical Care Medicine, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China (Tang ZH). Corresponding author: Tang Zhanhong, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Jan;29(1):71-74. doi: 10.3760/cma.j.issn.2095-4352.2017.01.015.
To discuss the influence of intermittently monitoring on endotracheal tube cuff pressure using handheld pressure gauge, and to provide some reference for the clinical work.
The experiment was carried out on the model of the glass tube, which was divided into three parts. Each part of the experiment was divided into normal pressure group and high pressure group according to the different inflation pressure target value. The endotracheal tube cuff pressure was determined intermittently by using the transparent tracheal models which had a static diameter of 2 cm. The target press value of normal pressure group was 32 cmHO (1 cmHO = 0.098 kPa) while that of high pressure group was 40 cmHO. The handheld pressure gauge was connected with the indicated cuff through a tee joint, and the pressure in the cuff in both groups was determined. The pressure loss caused by intermittent measurement of the two groups was compared. By switching the tee joint, the pressure loss through the gauge self-structure and the pressure loss when connecting and disconnecting the indicated cuff were determined to analyze the causes of pressure loss caused by intermittent measurement of pressure gauge.
The pressure loss caused by intermittent measurement of high pressure group was significantly higher than that of normal pressure group (cmHO: 15.10±0.43 vs. 10.19±0.45) with statistical significance (t = -24.875, P = 0.000). The pressure loss through the gauge self-structure of high pressure group was also significantly higher than that of normal pressure group (cmHO: 13.91±0.48 vs. 8.77±0.53), which showed a statistics significance (t = -22.854, P = 0.000). The pressure loss when connecting and disconnecting the indicated cuff of the normal pressure and high pressure groups were (1.33±0.49) cmHO and (1.23±0.55) cmHO, respectively, without statistics significance (t = 0.445, P = 0.662). It was figured that the total pressure loss caused by intermittent measurement of the endotracheal intubation cuff was approximately equal to the value of the pressure loss caused by the pressure gauge self-structure and the pressure loss when the indicated cuff was connected and disconnected [normal pressure group: (10.19±0.45) cmHO ≍ (8.77±0.53) cmHO + (1.33±0.49) cmHO, high pressure group: (15.10±0.43) cmHO ≍ (13.91±0.48) cmHO + (1.23±0.55) cmHO].
The intermittently monitoring on endotracheal tube cuff pressure is the main cause of the pressure loss. The total pressure loss consists of the pressure leak from the cuff to the gauge and the pressure leak when connecting and disconnecting the gauge and the indicated cuff during each test. When the pressure in the cuff is increased, it will cause more pressure loss.
探讨使用手持式压力计间歇监测气管导管套囊压力的影响，为临床工作提供参考。
在玻璃管模型上进行实验，分为三个部分。根据不同的充气压力目标值，每个实验部分又分为常压组和高压组。使用内径为2 cm的透明气管模型间歇性测定气管导管套囊压力。常压组的目标压力值为32 cmH₂O（1 cmH₂O = 0.098 kPa），高压组为40 cmH₂O。手持式压力计通过三通接头与指示套囊相连，测定两组套囊内的压力。比较两组间歇性测量引起的压力损失。通过切换三通接头，测定压力计自身结构引起的压力损失以及连接和断开指示套囊时的压力损失，以分析压力计间歇性测量引起压力损失的原因。
高压组间歇性测量引起的压力损失显著高于常压组（cmH₂O：15.10±0.43 vs. 10.19±0.45），差异有统计学意义（t = -24.875，P = 0.000）。高压组压力计自身结构引起的压力损失也显著高于常压组（cmH₂O：13.91±0.48 vs. 8.77±0.53），差异有统计学意义（t = -22.854，P = 0.000）。常压组和高压组连接和断开指示套囊时的压力损失分别为（1.33±0.49）cmH₂O和（1.23±0.55）cmH₂O，差异无统计学意义（t = 0.445，P = 0.662）。得出气管插管套囊间歇性测量引起的总压力损失约等于压力计自身结构引起的压力损失与连接和断开指示套囊时的压力损失之和[常压组：（10.19±0.45）cmH₂O ≍ （8.77±0.53）cmH₂O + （1.33±0.49）cmH₂O，高压组：（15.10±0.43）cmH₂O ≍ （13.91±0.48）cmH₂O + （1.23±0.55）cmH₂O]。
间歇性监测气管导管套囊压力是压力损失的主要原因。总压力损失包括每次测试期间从套囊到压力计的压力泄漏以及连接和断开压力计与指示套囊时的压力泄漏。当套囊内压力升高时，会导致更多的压力损失。
