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不同体位对机械通气患者气管内导管套囊压力的影响

The Effect of Different Body Positions on Endotracheal Tube Cuff Pressure in Patients under Mechanical Ventilation.

作者信息

Jalali Amir, Maleki Zohreh, Dinmohammadi Mohammadreza

机构信息

Department of Psychiatric Nursing, Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Department of Critical Care Nursing, Nursing and Midwifery School, Zanjan University of Medical Sciences, Zanjan, Iran.

出版信息

J Caring Sci. 2021 Nov 14;11(1):15-20. doi: 10.34172/jcs.2022.03. eCollection 2022 Mar.

Abstract

Maintaining endotracheal tube intracuff pressure (ETTICP) within an optimal range is crucial for effective ventilation and prevention of aspiration. This study aimed to determine the effect of changing body position on ETTICP in patients under mechanical ventilation. In the current single-group study, each patient was taken as his/her own control. Thirty patients who met the inclusion criteria were selected as the study sample. First, the patients were placed in a supine (flat) position, head of the bed was raised to 30 degrees, and ETTICP was set at 25 cmH O as the baseline. Then, the ETTICP changes in the three positions (left lateral, right lateral, and semi-fowler) were compared with the baseline. Interventions were made on a random basis among the patients. Data were analyzed by repeated-measures ANOVA using SPSS version 13. There was a significant difference among ETTICP means in three different body positions, so that ETTICP was higher in the left lateral position compared to other positions. Moreover, there was a significant difference among ETTICP means 0, 15, 45, and 90 minutes after changing the body position. ETTICP means after 0 and 15 minutes were significantly higher than other times compared to the baseline. ETTICP changes were affected by different body positions and the passage of time. Thus, regular monitoring and adjusting of ETTICP after any body positioning is essential, especially immediately and 15 minutes after repositioning.

摘要

将气管内导管套囊内压力(ETTICP)维持在最佳范围内对于有效通气和预防误吸至关重要。本研究旨在确定改变体位对机械通气患者ETTICP的影响。在当前的单组研究中,每位患者以自身作为对照。选取30例符合纳入标准的患者作为研究样本。首先,患者取仰卧(平)位,床头抬高至30度,将ETTICP设定为25 cmH₂O作为基线。然后,将三个体位(左侧卧位、右侧卧位和半坐卧位)时的ETTICP变化与基线进行比较。对患者进行随机干预。使用SPSS 13版通过重复测量方差分析对数据进行分析。三个不同体位的ETTICP均值之间存在显著差异,因此左侧卧位时的ETTICP高于其他体位。此外,改变体位后0、15、45和90分钟时的ETTICP均值之间存在显著差异。与基线相比,0和15分钟时的ETTICP均值显著高于其他时间。ETTICP变化受不同体位和时间推移的影响。因此,在任何体位调整后定期监测和调整ETTICP至关重要,尤其是在重新定位后立即和15分钟时。

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