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重症监护病房患者意外气管导管移位:三种不同气管导管固定胶带的随机比较

Accidental Endotracheal Tube Displacement in Intensive Care Unit Patients: A Randomized Comparison of Three Different Endotracheal Tube-securing Tapes.

作者信息

Ansari Md Parwaj H, Arun Nidhi, Dev Anand, Verma Ankita

机构信息

Department of Anesthesia and Critical Care Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

Department of Critical Care Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

出版信息

Indian J Crit Care Med. 2025 May;29(5):418-423. doi: 10.5005/jp-journals-10071-24960. Epub 2025 May 8.

Abstract

BACKGROUND AND AIMS

Several materials and techniques are used for securing the endotracheal tube (ETT). This randomized, controlled trial was conducted to compare three different types of fixation tapes: (1) Cloth-based, nonadhesive, nonelastic tape (gauze tape); (2) Silk-based, adhesive, nonelastic tape (Durapore™); and (3) Cloth-based, adhesive, elastic tape (Dynaplast™), with the primary objective to compare the incidence of displacement (≥1 cm) of ETT in intensive care unit (ICU) patients.

PATIENTS AND METHODS

This randomized prospective comparative trial was conducted on 150 ICU patients, of either gender between 16 and 80 years of age requiring endotracheal intubations. All patients were randomly allocated into groups A, B, and C. Endotracheal tube was secured with gauze tape, Durapore™, and Dynaplast™ in groups A, B, and C, respectively, with uniform technique. The final insertion depth of the ETT was marked, and displacement ≥ 1 cm was recorded. Ease of fixation, time taken, need for assistance, adhesive quality, and skin changes were also recorded and compared.

RESULTS

Endotracheal tube displacement ≥ 1 cm over 24 hours was recorded in 58.7, 35.4, and 29.8% of patients in tape gauze, Durapore™, and Dynaplast™, respectively ( = 11.372, = 0.011). Durapore™ and Dynaplast™ were quicker and easier to apply, but with a high incidence of skin complications.

CONCLUSION

Although no single material emerged superior in all aspects, our findings highlight the trade-offs between ease of application, risk of skin complications, and fixation security. The ideal fixation material may vary depending on patient characteristics, clinical context, and institutional resources.

HOW TO CITE THIS ARTICLE

Md Ansari PH, Arun N, Dev A, Verma A. Accidental Endotracheal Tube Displacement in Intensive Care Unit Patients: A Randomized Comparison of Three Different Endotracheal Tube-securing Tapes. Indian J Crit Care Med 2025;29(5):418-423.

摘要

背景与目的

有多种材料和技术用于固定气管内插管(ETT)。本随机对照试验旨在比较三种不同类型的固定胶带:(1)布基、无粘性、无弹性胶带(纱布胶带);(2)丝基、粘性、无弹性胶带(德普乐胶带™);(3)布基、粘性、弹性胶带(迪纳普拉斯胶带™),主要目的是比较重症监护病房(ICU)患者中气管内插管移位(≥1 cm)的发生率。

患者与方法

本随机前瞻性比较试验纳入了150例需要气管插管的16至80岁的ICU患者,性别不限。所有患者被随机分为A、B、C组。A、B、C组分别使用纱布胶带、德普乐胶带™和迪纳普拉斯胶带™以统一技术固定气管内插管。标记气管内插管的最终插入深度,并记录移位≥1 cm的情况。还记录并比较了固定的难易程度、所需时间、是否需要协助、粘性质量和皮肤变化。

结果

使用纱布胶带、德普乐胶带™和迪纳普拉斯胶带™的患者中,分别有58.7%、35.4%和29.8%在24小时内气管内插管移位≥1 cm(χ² = 11.372,P = 0.011)。德普乐胶带™和迪纳普拉斯胶带™应用起来更快更容易,但皮肤并发症发生率较高。

结论

虽然没有一种材料在所有方面都表现出色,但我们的研究结果突出了在应用便利性、皮肤并发症风险和固定安全性之间的权衡。理想的固定材料可能因患者特征、临床情况和机构资源而异。

如何引用本文

Md Ansari PH, Arun N, Dev A, Verma A. 重症监护病房患者意外气管内插管移位:三种不同气管内插管固定胶带的随机比较。《印度重症监护医学杂志》2025;29(5):418 - 423。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff98/12101974/28ffbc98f4eb/ijccm-29-5-418-g001.jpg

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