Nursing Department, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
College of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China.
Nurs Open. 2024 Jun;11(6):e2187. doi: 10.1002/nop2.2187.
The commonly recommended endotracheal tube cuff pressure is 20-30 cmHO. However, some patients require a cuff pressure of >30 cmHO to prevent air leakage. The study aims to determine the risk factors that contribute to the endotracheal tube cuff pressure of >30 cmHO to prevent air leakage.
A multi-centre prospective observational study.
Eligible patients undergoing mechanical ventilation in the intensive care unit of three hospitals between March 2020 and July 2022 were included. The endotracheal tube cuff pressure to prevent air leakage was determined using the minimal occlusive volume technique. The patient demographics and clinical information were collected.
A total of 284 patients were included. Among these patients, 55 (19.37%) patients required a cuff pressure of >30 cmHO to prevent air leakage. The multivariate logistic regression results revealed that the surgical operation (odds ratio [OR]: 8.485, 95% confidence interval [CI]: 1.066-67.525, p = 0.043) was inversely associated with the endotracheal tube cuff pressure of >30 cmHO, while the oral intubation route (OR: 0.127, 95% CI: 0.022-0.750, p = 0.023) and cuff inner diameter minus tracheal area (OR: 0.949, 95% CI: 0.933-0.966, p < 0.001) were negatively associated with the endotracheal tube cuff pressure of >30 cmHO. Therefore, a significant number of patients require an endotracheal tube cuff pressure of ＞30 cmHO to prevent air leakage. Several factors, including the surgical operation, intubation route, and difference between the cuff inner diameter and tracheal area at the T3 vertebra, should be considered when determining the appropriate cuff pressure during mechanical ventilation.
通常建议的气管导管套囊压力为 20-30cmH₂O。然而，一些患者需要 >30cmH₂O 的套囊压力来防止漏气。本研究旨在确定导致气管导管套囊压力 >30cmH₂O 以防止漏气的危险因素。
一项多中心前瞻性观察研究。
纳入 2020 年 3 月至 2022 年 7 月期间在三家医院的重症监护病房接受机械通气的符合条件的患者。使用最小闭塞容积技术确定防止漏气的气管导管套囊压力。收集患者的人口统计学和临床信息。
共纳入 284 例患者。其中，55 例（19.37%）患者需要 >30cmH₂O 的套囊压力来防止漏气。多变量逻辑回归结果显示，手术操作（比值比 [OR]：8.485，95%置信区间 [CI]：1.066-67.525，p=0.043）与气管导管套囊压力 >30cmH₂O 呈负相关，而口腔插管途径（OR：0.127，95%CI：0.022-0.750，p=0.023）和套囊内直径与气管面积之差（OR：0.949，95%CI：0.933-0.966，p<0.001）与气管导管套囊压力 >30cmH₂O 呈负相关。因此，相当一部分患者需要气管导管套囊压力 >30cmH₂O 来防止漏气。在确定机械通气期间合适的套囊压力时，应考虑手术操作、插管途径以及 T3 椎体处套囊内直径与气管面积之差等因素。
