Hannallah M S, Benumof J L, McCarthy P O, Liang M
Department of Anesthesia, Georgetown University Medical Center, Washington, DC 20007.
Anesth Analg. 1993 Nov;77(5):990-4. doi: 10.1213/00000539-199311000-00020.
Correct inflation of the cuff of any breathing tube is important; overinflation can damage the mucosa of the tracheobronchial tree and underinflation will cause a leak. Three different techniques to determine cuff seal/leak during inflation of the bronchial cuff of left double-lumen endobronchial tubes (DLT) were each evaluated in 10 patients. DLT size was chosen from a formula based on the patient's height and sex. In the first technique, designated the positive pressure technique of bronchial cuff inflation (PPT), the bronchial side of the DLT is pressurized during connection of the tracheal side to a beaker of water. Air bubbles will appear in the beaker in the absence of bronchial seal. The second technique, designated the CO2 analysis technique of bronchial cuff inflation (CAT), is based on analysis of CO2 content of gas sampled from the tracheal side of the DLT during ventilation of its bronchial side. When the bronchus is sealed, the normal CO2 waveform changes to a flat line. In the third technique, designated the negative pressure technique of bronchial cuff inflation (NPT), suction is applied to the tracheal side of the DLT. The absence of bronchial seal will result in collapse of the reservoir bag within a breathing system connected to the bronchial side of the tube. The bronchial sealing volumes were 1.1 +/- 0.9 mL, 0.9 +/- 0.7 mL, and 0.3 +/- 0.4 mL (mean +/- SD) when measured with the PPT, CAT, and NPT, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
正确给任何呼吸管的套囊充气很重要；充气过度会损伤气管支气管树的黏膜，充气不足则会导致漏气。对10名患者分别评估了三种不同的确定左双腔支气管内导管（DLT）支气管套囊充气时套囊密封/漏气情况的技术。DLT的尺寸根据患者的身高和性别通过公式选择。在第一种技术中，即支气管套囊充气的正压技术（PPT），在将气管侧连接到一杯水时，对DLT的支气管侧加压。如果没有支气管密封，烧杯中会出现气泡。第二种技术，即支气管套囊充气的二氧化碳分析技术（CAT），基于在其支气管侧通气时从DLT气管侧采集的气体的二氧化碳含量分析。当支气管密封时，正常的二氧化碳波形会变为一条平线。在第三种技术中，即支气管套囊充气的负压技术（NPT），对DLT的气管侧施加吸力。没有支气管密封会导致连接到导管支气管侧的呼吸系统内的贮气囊塌陷。分别用PPT、CAT和NPT测量时，支气管密封容积分别为1.1±0.9 mL、0.9±0.7 mL和0.3±0.4 mL（平均值±标准差）。（摘要截短于250字）
