University Veterinary Teaching Hospital, School of Veterinary Science, University of Sydney, Camperdown, Australia.
J Feline Med Surg. 2020 Jul;22(7):641-647. doi: 10.1177/1098612X19871701. Epub 2019 Aug 29.
The aim of this study was to compare four inflation techniques on endotracheal tube cuff (ETC) pressure using a feline airway simulator.
Ten participants used four different endotracheal cuff inflation techniques to inflate the cuff of a low-pressure, high-volume endotracheal tube within a feline airway simulator. The simulator replicated an average-sized feline trachea, intubated with a 4.5 mm endotracheal tube, connected to a circle breathing system and pressure-controlled ventilation with oxygen and medical air. Participants inflated the ETC: by pilot balloon palpation (P); by instilling the minimum occlusive volume (MOV) required for loss of airway leaks during mechanical ventilation; until a passive release of pressure with use of a loss-of-resistance syringe (LOR); and with use of a syringe with a digital pressure reader (D) specifically designed for endotracheal cuff inflation. Intracuff pressure was measured by a manometer obscured to participants. The ideal pressure was considered to be between 20 and 30 cmHO. Data were analysed by Shapiro-Wilk, Kruskal-Wallis and χ tests, as appropriate.
Participants were eight veterinarians and two veterinary nurses with additional training in anaesthesia. Measured median intracuff pressures for P, MOV, LOR and D, respectively, were 25 cmHO (range 4-74 cmHO), 41 cmHO (range 4-70 cmHO), 31 cmHO (range 18-64 cmHO) and 22 cmHO (range 20-30 cmHO). D performed significantly better ( <0.001) than all other techniques, with no difference between the other techniques.
Use of D for cuff inflation achieved optimal cuff pressures. There may be high operator-dependent variability in the cuff pressures achieved with the use of P, MOV or LOR inflation techniques. As such, a cuff manometer is recommended when using any of these techniques.
本研究旨在通过猫气道模拟器比较四种充气技术对气管导管套囊（ETC）压力的影响。
10 名参与者使用四种不同的气管导管套囊充气技术，在猫气道模拟器中对低压高容量气管导管的套囊进行充气。模拟器复制了一个平均大小的猫气管，用 4.5 毫米的气管导管插管，连接到一个圆形呼吸回路和压力控制通气，使用氧气和医用空气。参与者通过以下方法对 ETC 进行充气：通过导气管球囊触诊（P）；通过注入机械通气时失去气道漏诊所需的最小闭塞容积（MOV）；使用阻力损失注射器（LOR）达到被动压力释放；以及使用专门设计用于气管导管套囊充气的带数字压力读数器（D）的注射器。通过对参与者进行遮挡的压力计测量套囊内压。理想压力被认为在 20 至 30 cmH2O 之间。数据通过 Shapiro-Wilk、Kruskal-Wallis 和 χ 检验进行分析，具体取决于数据类型。
参与者包括 8 名兽医和 2 名兽医护士，他们在麻醉方面接受了额外的培训。P、MOV、LOR 和 D 分别测量的套囊内压中位数为 25 cmH2O（范围 4-74 cmH2O）、41 cmH2O（范围 4-70 cmH2O）、31 cmH2O（范围 18-64 cmH2O）和 22 cmH2O（范围 20-30 cmH2O）。D 明显优于所有其他技术（<0.001），而其他技术之间没有差异。
使用 D 充气可达到最佳套囊压力。使用 P、MOV 或 LOR 充气技术可能会导致套囊压力存在高度的操作者依赖性变异性。因此，在使用这些技术中的任何一种技术时，都建议使用套囊压力表。
