通气模式影响气管导管套囊压力吗？

以下文章来源于小麻哥的日常 ，作者两只小绵羊

本文由“小麻哥的日常”授权转载

摘要译文（供参考）

压力控制和容量控制通气对全身麻醉和机械通气患者气管插管套囊压力的影响比较：一项平行随机临床试验

背景：

气管插管和机械通气是手术室和重症监护病房的普遍干预措施。最近，气管插管套囊压力的并发症已成为人们关注的话题。因此，本研究比较了压力控制和容量控制通气模式对全身麻醉和机械通气患者气管插管套囊压力的影响。

方法：

在这项三盲随机临床试验中，根据纳入标准，将50名接受开放肢体手术和腹股沟疝的患者分为两组，每组25人。插管后，一组在压力控制通气模式下进行通气，另一组在容量控制通气模式下进行通气。在两组中，使用压力计，首先在25-30厘米水柱的范围内调节套囊的压力。然后，以10，20和30分钟的间隔测量套囊压力。采用独立t检验和双向重复测量方差分析对数据进行统计分析。

结果：

本研究的结果表明，两个研究组的套囊压力随着时间的推移而显著降低（F = 117.7，P < 0.001）。然而，使用Greenhouse-Geisser校正的重复测量方差分析显示时间和组之间没有交互作用（F = 0.019，P = 0.98）。两组套囊压力差异无统计学意义（F = 0.56，P = 0.458）。

结论：

由于两组的套囊压力随着时间的推移均显著降低，因此持续监测接受机械通气的患者的气管插管套囊压力至关重要。因此，建议将套囊压力保持在推荐范围内，以防止因气囊压力降低而导致的并发症，例如误吸和通气减少。

试用注册：

该研究于2019年02月23日在伊朗临床试验注册中心注册 （试验注册号：IRCT20181018041376N1）。

关键字：

气管插管套囊压力;机械通气;压力控制通气;容量控制通风。

原文摘要

Comparison of the effect of pressure control and volume control ventilation on endotracheal tube cuff pressure in patients undergoing general anesthesia and mechanical ventilation: a parallel randomized clinical trial

Background:Endotracheal intubation and mechanical ventilation are prevalent interventions in the operating room and intensive care unit. Recently, the complications of endotracheal tube cuff pressure have been a topic of interest. Therefore, this study compared the effect of pressure control and volume control ventilation modes on the endotracheal cuff pressure rate in patients undergoing general anesthesia and mechanical ventilation.

Methods:In this triple-blinded randomized clinical trial, 50 patients undergoing open limb surgery and inguinal hernia were allocated to two groups of 25 based on inclusion criteria. After intubation, one group underwent ventilation on the pressure control ventilation mode, and the other underwent ventilation on the volume control ventilation mode. In both groups, using a manometer, the cuff's pressure was first adjusted in the range of 25-30 cm of water. Then, the cuff pressure was measured at 10, 20, and 30 min intervals. The data were statistically analyzed using independent t-test, and two-way repeated measures ANOVA.

Results:The present study's findings showed that cuff pressure has significantly decreased over time in both study groups (F = 117.7, P < 0.001). However, a repeated measures ANOVA with a Greenhouse-Geisser correction showed no interaction between time and groups (F = 0.019, P = 0.98). The two groups had no significant difference in cuff pressure (F = 0.56, P = 0.458).

Conclusion:Since the cuff pressure has been significantly reduced in both groups over time, continuous monitoring of endotracheal tube cuff pressure in patients undergoing mechanical ventilation is essential. Therefore, it is suggested to keep the cuff pressure within the recommended range to prevent complications resulting from cuff pressure reduction, such as aspiration and ventilation decrease.

Trial registration:The study was registered in the Iranian Registry of Clinical Trial on 23/02/2019 (trial registration number: IRCT20181018041376N1).

Keywords:Endotracheal tube cuff pressure; Mechanical ventilation; Pressure control ventilation; Volume control ventilation.

免责声明：

本公众平台所刊载原创或转载内容不代表米勒之声的观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

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编辑：Michel.米萱

校对：MiSuper.米超

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