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兽医学中气管内导管套囊充气及压力验证的方法:当前实践调查问卷

Methods Used for Endotracheal Tube Cuff Inflation and Pressure Verification in Veterinary Medicine: A Questionnaire on Current Practice.

作者信息

Veen Iris, de Grauw Janny C

机构信息

Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands.

出版信息

Animals (Basel). 2022 Nov 8;12(22):3076. doi: 10.3390/ani12223076.

Abstract

Endotracheal intubation is a routine procedure in veterinary anaesthesia, yet no consensus guidelines exist for endotracheal tube (ETT) cuff inflation and pressure measurement. The aim of this study was to assess current practice of ETT cuff inflation and seal verification in veterinary medicine. An online questionnaire was distributed among veterinary professionals who administer anaesthesia, comprising six demographic and twelve ETT cuff-related questions per species. N = 348 questionnaires were completed. Cuff pressure was measured by 30% of respondents in cats, 32% in dogs and 9% in both farm animals and horses. Anaesthesia diplomates were not more likely to measure cuff pressure than others, except in cats (OR: 1.8; 95% CI: 1.1−2.9). The most frequently selected recommended range of cuff pressure was 20−30 cm H2O, regardless of species, although >30 cm H2O was selected significantly more often in horses compared to dogs, cats and farm animals. The preferred technique to verify cuff seal was minimal occlusive volume in dogs, cats and farm animals, whereas in horses, the preferred method was verification of normal capnogram waveform. ETT cuff pressure measurement remains uncommon in veterinary anaesthesia. The development of consensus recommendations for cuff inflation, including evidence-based target cuff pressure ranges for various species and different ETT models or materials, can help to improve practice.

摘要

气管插管是兽医麻醉中的常规操作,但对于气管导管(ETT)套囊充气和压力测量尚无共识性指南。本研究的目的是评估兽医领域中ETT套囊充气和密封验证的当前实践情况。在实施麻醉的兽医专业人员中发放了一份在线调查问卷,每个物种包含六个关于人口统计学的问题和十二个与ETT套囊相关的问题。共完成了348份问卷。30%的受访者对猫测量了套囊压力,32%的受访者对狗测量了套囊压力,9%的受访者对农场动物和马都测量了套囊压力。麻醉专科医生测量套囊压力的可能性并不比其他人更高,猫除外(比值比:1.8;95%置信区间:1.1 - 2.9)。无论物种如何,最常选择的推荐套囊压力范围是20 - 30 cmH₂O,不过与狗、猫和农场动物相比,马显著更常选择>30 cmH₂O。验证套囊密封的首选技术在狗、猫和农场动物中是最小闭合容量,而在马中,首选方法是验证正常的二氧化碳波形图。在兽医麻醉中,ETT套囊压力测量仍然不常见。制定关于套囊充气的共识性建议,包括基于证据的各种物种以及不同ETT型号或材料的目标套囊压力范围,有助于改善实践。

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