Ikeda S, Schweiss J F
Can Anaesth Soc J. 1980 Sep;27(5):453-7. doi: 10.1007/BF03007043.
Changes in the volume of tracheal tube cuffs were examined during extracorporeal circulation to determine the influence of the composition of the inspired gases and of the gas within the cuff. The study was carried out on 90 patients who underwent coronary artery bypass grafting. When the cuff contains nitrous oxide at the start of extracorporeal circulation, the cuff volume decreases during bypass regardless of the composition of the inspired gases. When the cuff is filled with air or 100 per cent oxygen at the start of extracorporeal circulation and the inspired gas mixture consists of nitrous oxide and oxygen the cuff volume increases. When the cuff is deflated and then refilled with either room air or oxygen at the beginning of the extracorporeal circulation and the lungs are inflated with oxygen, the cuff volume change is minimal during bypass. This combination of gas prevents any undesirable change in the cuff volume. It appears desirable to monitor the tracheal tube cuff volume or pressure and to maintain a constant pressure and volume during bypass to prevent deflation and silent aspiration associated with cuff deflation, as well as to avoid mucosal damage due to excessive pressure in the cuff.
在体外循环期间检查气管导管套囊的容积变化，以确定吸入气体成分及套囊内气体对其的影响。该研究对90例行冠状动脉旁路移植术的患者进行。在体外循环开始时，若套囊内含有氧化亚氮，无论吸入气体成分如何，在旁路循环期间套囊容积都会减小。当体外循环开始时套囊充入空气或纯氧，且吸入气体混合物由氧化亚氮和氧气组成时，套囊容积会增加。当在体外循环开始时套囊放气，然后再充入室内空气或氧气，且肺部用氧气充气时，在旁路循环期间套囊容积变化很小。这种气体组合可防止套囊容积出现任何不良变化。监测气管导管套囊容积或压力，并在旁路循环期间维持恒定的压力和容积，以防止与套囊放气相关的放气和无声误吸，以及避免因套囊内压力过高导致的黏膜损伤，似乎是很有必要的。
