Benzidi Younès, Duburcq Thibault, Mathieu Daniel, Parmentier-Decrucq Erika
Intensive Care Unit and Hyperbaric Center, Lille University Hospital, Lille, France.
Corresponding author: Erika Parmentier-Decrucq, Pôle de Réanimation Médicale, Hôpital Salengro, CHU, 2 rue Emile Laisne, 59037 Lille cedex, France,
Diving Hyperb Med. 2020 Sep 30;50(3):230-237. doi: 10.28920/dhm50.3.230-237.
Inflating endotracheal tube cuffs using water instead of air before hyperbaric oxygen treatment (HBOT) is common. The objective of this study was to assess cuff pressure (P), when the cuff was inflated using water, in normobaric conditions and during HBOT.
This was a prospective, observational study taking place in hyperbaric centre and intensive care unit of the University Hospital of Lille. Every patient who required tracheal intubation and HBOT at 253.3 kPa (2.5 atmospheres absolute [atm abs]) was included. P was measured using a pressure transductor connected to the cuff inflating port. Measurements were performed at 'normobaria' (1 atm abs) and during HBOT at 2.5 atm abs.
Thirty patients were included between February and April 2016. Recordings were analysable in 27 patients. Mean P at normobaria was 60.8 (SD 42) cmHO. Nineteen (70%) of patients had an excessive P (higher than 30 cmHO). Coefficient of variation was 69%. Mean P at 2.5 atm abs was 51.6 (40.7) cmHO, significantly lower than at normobaria (P < 0.0001). Coefficient of variation was 79%. In only five (18%) patients was P < 20 cmHO at 2.5 atm abs.
In normobaric conditions, when the cuff was inflated using water and not specifically controlled P was not predictable. The cuff was typically over-inflated exceeding safe pressure. During HBOT P decreased slightly.
在高压氧治疗（HBOT）前使用水而非空气给气管内导管套囊充气很常见。本研究的目的是评估在常压条件下以及HBOT期间用水给套囊充气时的套囊压力（P）。
这是一项前瞻性观察性研究，在里尔大学医院的高压氧中心和重症监护病房进行。纳入每一位在253.3 kPa（2.5绝对大气压[atm abs]）下需要气管插管和HBOT的患者。使用连接到套囊充气端口的压力传感器测量P。测量在“常压”（1 atm abs）下以及在2.5 atm abs的HBOT期间进行。
2016年2月至4月纳入了30例患者。27例患者的记录可进行分析。常压下的平均P为60.8（标准差42）cmH₂O。19例（70%）患者的P过高（高于30 cmH₂O）。变异系数为69%。2.5 atm abs时的平均P为51.6（40.7）cmH₂O，显著低于常压时（P < 0.0001）。变异系数为79%。在2.5 atm abs时，只有5例（18%）患者的P < 20 cmH₂O。
在常压条件下，当用水给套囊充气且未进行专门控制时，P不可预测。套囊通常过度充气超过安全压力。在HBOT期间，P略有下降。
