Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
School of Nursing, Southern Medical University, Guangzhou, 510515, China.
J Clin Monit Comput. 2022 Apr;36(2):521-528. doi: 10.1007/s10877-021-00681-5. Epub 2021 Mar 11.
To evaluate the effect of different inflation volume on the measurement accuracy of the modified cuff pressure measurement method in different shapes of cuffs, so as to provide reference for the correct monitoring of cuff pressure in clinic. In vitro study: The traditional cuff pressure measurement method (the cuff pressure gauge before measurement shows 0 cm HO) and the modified cuff pressure measurement method (the cuff pressure before measurement shows 25 cm HO, 28 cm HO, 30 cm HO or 32 cm HO) were used to measure cylindrical and tapered cuffs, and the effect of different inflation volume on cuff pressure was analyzed statistically. Clinical study: patients with the artificial airway established by orotracheal intubation or tracheotomy in Neuro-ICU were prospectively selected as subjects, and the measurement procedure was the same as in vitro study. In vitro study showed that the pressure loss values of cylindrical cuff and tapered cuff using the traditional cuff pressure measurement method were (3.75 ± 0.31) cm HO and (4.92 ± 0.44) cm HO, respectively, and clinical study showed that the pressure loss values were (5.07 ± 0.83) cm HO and (5.17 ± 0.93) cm HO, respectively. The actual measured values measured by the traditional cuff pressure measurement method of the two cuff shapes were compared with the corrected target value of 28 cm HO, and the differences were statistically significant (P < 0.000). Both in vitro and clinical study had shown that all differences between the actual measured value and the corrected target value using the modified cuff pressure measurement method (measured with 25 cm HO, 30 cm HO, 32 cm HO) were statistically significant (P < 0.000), and the range of overall differences was (0-1.23 ± 0.25) cm HO. In vitro study had shown that the pressure variation coefficient (CV) of the tapered cuff was greater than that of the cylindrical cuff, and the difference was statistically significant (3.08 ± 0.25 VS 2.41 ± 0.21, P < 0.000). The traditional cuff pressure measurement method can directly lead to the cuff pressure drop, which is easy to cause the leakage of secretions on the cuffs and the misjudgment of the cuff pressure by medical personnel. However, the modified cuff pressure measurement method can effectively reduce cuff pressure loss, and taking the actual cuff pressure value as the inflation volume is the highest measurement accuracy.The tapered cuff is more susceptible to air volume, so it is necessary to pay attention to its measurement and correction in clinical practice.
为了评估不同充气量对改良袖口压力测量方法在不同形状袖口测量精度的影响，为临床正确监测袖口压力提供参考。体外研究：采用传统袖口压力测量方法（测量前袖带压力计显示 0 cm HO）和改良袖口压力测量方法（测量前袖带压力计显示 25 cm HO、28 cm HO、30 cm HO 或 32 cm HO）测量圆柱形和锥形袖口，统计分析不同充气量对袖口压力的影响。临床研究：选择神经重症监护病房经口或气管切开建立人工气道的患者为研究对象，测量程序与体外研究相同。体外研究显示，采用传统袖口压力测量方法测量圆柱形袖口和锥形袖口的压力损失值分别为（3.75±0.31）cm HO 和（4.92±0.44）cm HO，临床研究显示，压力损失值分别为（5.07±0.83）cm HO 和（5.17±0.93）cm HO。将两种袖口形状的传统袖口压力测量方法实际测量值与 28 cm HO 的校正目标值进行比较，差异有统计学意义（P<0.000）。体外和临床研究均显示，改良袖口压力测量方法（测量值为 25 cm HO、30 cm HO、32 cm HO）的实际测量值与校正目标值之间的所有差异均有统计学意义（P<0.000），整体差异范围为（0-1.23±0.25）cm HO。体外研究显示，锥形袖口的压力变异系数（CV）大于圆柱形袖口，差异有统计学意义（3.08±0.25 VS 2.41±0.21，P<0.000）。传统袖口压力测量方法可直接导致袖口压力下降，容易导致袖口分泌物泄漏，医务人员误判袖口压力。但是，改良袖口压力测量方法可以有效降低袖口压力损失，以实际袖口压力值作为充气量，测量精度最高。锥形袖口对气量更敏感，因此在临床实践中需要注意其测量和校正。
