Burns S M, Spilman M, Wilmoth D, Carpenter R, Turrentine B, Wiley B, Marshall M, Martens S, Burns J E, Truwit J D
University of Virginia Health Sciences Center, Charlottesville 22903, USA.
Heart Lung. 1998 Jan-Feb;27(1):58-62. doi: 10.1016/s0147-9563(98)90070-x.
To determine the incidence of obstruction and colonization in adult patients in the surgical and medical intensive care units who received inner cannula changes daily versus those who did not.
Quasi-experimental prospective study using a convenience sample of patients randomly assigned to one of two methods.
Mid-Atlantic university-affiliated tertiary care center.
Sixty patients within 24 hours of receiving a surgical tracheostomy.
Obstruction and bacterial colonization of inner cannula.
All inner cannulas were checked daily for obstruction and cultured on postoperative days 1 and 3.
No statistically significant difference was noted in colonization (p = 0.13) between protocols, and no obstructions were noted in either.
The study suggests that the routine practice in critical care units of changing tracheostomy inner cannulas may be unnecessary. Although the results of this study are limited, and may not be generalized to other populations, it demonstrates that practice standards related to the care of tracheostomy inner cannula need to be challenged.
确定在外科和内科重症监护病房中，每日更换气管内套管的成年患者与未每日更换的成年患者的梗阻发生率和定植发生率。
采用便利抽样，将患者随机分配至两种方法之一的准实验性前瞻性研究。
大西洋中部地区大学附属三级护理中心。
60例接受外科气管切开术24小时内的患者。
气管内套管的梗阻和细菌定植情况。
每天检查所有气管内套管是否梗阻，并在术后第1天和第3天进行培养。
两种方案之间在定植方面未发现统计学上的显著差异（p = 0.13），且两种方案均未发现梗阻情况。
该研究表明，重症监护病房常规更换气管切开术气管内套管的做法可能没有必要。尽管本研究结果有限，可能无法推广至其他人群，但它表明与气管内套管护理相关的实践标准需要受到质疑。
