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体外循环心脏手术期间气管导管套囊压力变化的评估

Evaluation of the endotracheal tube cuff pressure changes during cardiac operations under cardiopulmonary bypass.

作者信息

Mahoori Alireza, Khanahmadi Shahriar, Khanahmadi Shima, Parvin Karami Nasim, Mokhtarzadehazar Peyman

机构信息

Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran.

Urmia University of Medical Science, Urmia, Iran.

出版信息

J Cardiovasc Thorac Res. 2023;15(1):51-56. doi: 10.34172/jcvtr.2023.31733. Epub 2023 Mar 16.

Abstract

Tracheal intubation is used for most operations under general anesthesia. Prolonged hyperinflation of the tube cuff can compromise tracheal mucosal perfusion, and low pressure of the cuff may cause some other complications. The aim of this study was the evaluation of changes in intra-cuff pressure in patients undergoing cardiac surgeries under cardiopulmonary bypass. In an observational study 120 patient's candidate to cardiac operations under cardiopulmonary bypass were enrolled. After induction of anesthesia and tracheal intubation by same tracheal tubes, tracheal tube cuff pressure was adjusted to 20-25 mm Hg (T0). Then the cuff pressure was measured at beginning of CPB (Cardio Pulmonary Bypass) (T1), at 30º hypothermia (T2) and after separation from CPB (T3). The mean cuff pressure was 33.5±7.3, 28.9±5.4, 25.6±5.2 and 28.1±3.7 at T0, T1, T2 and T3 respectively. Intra- cuff pressure changed significantly during cardiopulmonary bypass. The mean intra-cuff pressure was decreased during hypothermic cardiopulmonary bypass. The decrease in cuff pressure may protect the tracheal mucosa against hypotensive ischemic injury in these patients.

摘要

大多数全身麻醉手术都采用气管插管。气管导管套囊长时间过度充气会损害气管黏膜灌注,而套囊压力过低可能会引发其他一些并发症。本研究的目的是评估体外循环下心脏手术患者套囊内压力的变化。在一项观察性研究中,纳入了120例拟行体外循环心脏手术的患者。在使用相同气管导管进行麻醉诱导和气管插管后,将气管导管套囊压力调整至20 - 25 mmHg(T0)。然后在体外循环开始时(T1)、体温降至30℃时(T2)以及体外循环结束后(T3)测量套囊压力。在T0、T1、T2和T3时,套囊平均压力分别为33.5±7.3、28.9±5.4、25.6±5.2和28.1±3.7。在体外循环期间,套囊内压力发生了显著变化。在低温体外循环期间,套囊平均压力降低。套囊压力降低可能会保护这些患者的气管黏膜免受低血压缺血性损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a519/10278193/f789573f0b1d/jcvtr-15-51-g001.jpg

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