Antony Kathleen M, Racusin Diana A, Belfort Michael A, Dildy Gary A
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin.
AJP Rep. 2017 Apr;7(2):e86-e92. doi: 10.1055/s-0037-1602657.
Uterine tamponade by fluid-filled balloons is now an accepted method of controlling postpartum hemorrhage. Available tamponade balloons vary in design and material, which affects the filling attributes and volume at which they rupture. We aimed to characterize the filling capacity and pressure-volume relationship of various tamponade balloons. Balloons were filled with water ex vivo. Intraluminal pressure was measured incrementally (every 10 mL for the Foley balloons and every 50 mL for all other balloons). Balloons were filled until they ruptured or until 5,000 mL was reached. The Foley balloons had higher intraluminal pressures than the larger-volume balloons. The intraluminal pressure of the Sengstaken-Blakemore tube (gastric balloon) was initially high, but it decreased until shortly before rupture occurred. The Bakri intraluminal pressure steadily increased until rupture occurred at 2,850 mL. The condom catheter, BT-Cath, and ebb all had low intraluminal pressures. Both the BT-Cath and the ebb remained unruptured at 5,000 mL. In the setting of acute hemorrhage, expeditious management is critical. Balloons that have a low intraluminal pressure-volume ratio may fill more rapidly, more easily, and to greater volumes. We found that the BT-Cath, the ebb, and the condom catheter all had low intraluminal pressures throughout filling.
用充液球囊进行子宫压迫止血现已成为控制产后出血的一种公认方法。现有的压迫止血球囊在设计和材料上各不相同，这会影响其充盈特性以及破裂时的容量。我们旨在描述各种压迫止血球囊的充盈能力和压力 - 容量关系。
球囊在体外用水充盈。逐步测量腔内压力（Foley球囊每10 mL测量一次，其他所有球囊每50 mL测量一次）。球囊持续充盈直至破裂或达到5000 mL。
Foley球囊的腔内压力高于大容量球囊。Sengstaken - Blakemore管（胃囊）的腔内压力最初较高，但在破裂前不久会下降。Bakri球囊的腔内压力持续稳定升高，直至在2850 mL时破裂。避孕套导管、BT - Cath和ebb的腔内压力均较低。BT - Cath和ebb在5000 mL时均未破裂。
在急性出血的情况下，迅速处理至关重要。腔内压力 - 容量比低的球囊可能充盈得更快、更容易且容量更大。我们发现，BT - Cath、ebb和避孕套导管在整个充盈过程中腔内压力均较低。
