Sosis M B, Braverman B
Department of Anesthesiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
J Clin Laser Med Surg. 1996 Apr;14(2):93-5. doi: 10.1089/clm.1996.14.93.
The occurrence of airway fires during laser airway surgery necessitates the use of special techniques to improve patient safety. For example, it is recommended that the endotracheal tube cuff be inflated with saline. However, in the event of an endotracheal tube fire, the tube must be quickly removed. This study was designed to determine the time necessary for red rubber (RR) or polyvinylchloride (PVC) endotracheal tubes to be removed from a model airway after inflating the cuffs with saline. A model larynx and trachea was suspended vertically. It was intubated with either 7.0 RR or PVC endotracheal tubes. Six milliliters of saline was used to inflate the endotracheal tube cuffs. After inflation, a clamp was used to occlude the pilot tube on the RR endotracheal tubes. A 4-lb weight was then suspended from the endotracheal tube. The time to spontaneous extubation of the model trachea after unclamping the pilot tubes on 12 RR endotracheal tubes was determined. For the PVC endotracheal tubes, the times to spontaneous extubation using the 4-lb weight were determined in 12 endotracheal tubes after cutting the pilot tube and in 12 by maximum aspiration of the saline from the endotracheal tube cuff with a 10-ml syringe. A time of 0.94 +/- 0.10 sec (mean +/- SD) was required for spontaneous extubation of the RR endotracheal tubes after unclamping the pilot tube. For the PVC endotracheal tubes, extubation occurred 3.28 +/- 1.08 and 1.81 +/- 0.60 sec after cutting the pilot tube or deflating the cuff with a syringe, respectively. The mean times for each of the 3 groups were significantly different (p < 0.05) from each other as determined by the ANOVA. This study shows that if PVC endotracheal tubes are used, deflation of the saline-filled cuff by aspiration with a 10-ml syringe is faster than cutting the pilot tube. Unclamping the pilot tube on the RR endotracheal tubes resulted in the fastest time to endotracheal extubation.
激光气道手术期间气道火灾的发生使得必须采用特殊技术来提高患者安全性。例如，建议用盐水充盈气管内导管的套囊。然而，万一发生气管内导管起火，必须迅速移除导管。本研究旨在确定用盐水充盈套囊后，红色橡胶（RR）或聚氯乙烯（PVC）气管内导管从模型气道中移除所需的时间。一个模型喉和气管垂直悬挂。用7.0的RR或PVC气管内导管进行插管。用6毫升盐水充盈气管内导管的套囊。充盈后，用夹子夹住RR气管内导管上的引导管。然后将一个4磅重的物体悬挂在气管内导管上。确定在松开12根RR气管内导管上的引导管后模型气管自主拔管的时间。对于PVC气管内导管，在切断引导管后，对12根气管内导管使用4磅重的物体确定自主拔管时间，并通过用10毫升注射器从气管内导管套囊中最大程度抽吸盐水对另外12根气管内导管确定自主拔管时间。松开引导管后，RR气管内导管自主拔管需要0.94±0.10秒（平均值±标准差）。对于PVC气管内导管，切断引导管或用注射器使套囊放气后，拔管分别发生在3.28±1.08秒和1.81±0.60秒。通过方差分析确定，3组中每组的平均时间彼此之间有显著差异（p<0.05）。本研究表明，如果使用PVC气管内导管，用10毫升注射器抽吸使充满盐水的套囊放气比切断引导管更快。松开RR气管内导管上的引导管导致气管内拔管时间最快。
