Ten participants used four different endotracheal cuff inflation techniques to inflate the cuff of a low-pressure, high-volume endotracheal tube within a feline airway simulator. The simulator replicated an average-sized feline trachea, intubated with a 4.5 mm endotracheal tube, connected to a circle breathing system and pressure-controlled ventilation with oxygen and medical air. Participants inflated the ETC: by pilot balloon palpation (P); by instilling the minimum occlusive volume (MOV) required for loss of airway leaks during mechanical ventilation; until a passive release of pressure with use of a loss-of-resistance syringe (LOR); and with use of a syringe with a digital pressure reader (D) specifically designed for endotracheal cuff inflation. Intracuff pressure was measured by a manometer obscured to participants. The ideal pressure was considered to be between 20 and 30 cmH2O. Data were analysed by Shapiro-Wilk, Kruskal-Wallis and χ2 tests, as appropriate.
Participants were eight veterinarians and two veterinary nurses with additional training in anaesthesia. Measured median intracuff pressures for P, MOV, LOR and D, respectively, were 25 cmH2O (range 4-74 cmH2O), 41 cmH2O (range 4-70 cmH2O), 31 cmH2O (range 18-64 cmH2O) and 22 cmH2O (range 20-30 cmH2O). D performed significantly better (P <0.001) than all other techniques, with no difference between the other techniques.
Use of D for cuff inflation achieved optimal cuff pressures. There may be high operator-dependent variability in the cuff pressures achieved with the use of P, MOV or LOR inflation techniques. As such, a cuff manometer is recommended when using any of these techniques.
十名参与者使用了四种不同的气管内袖带充气技术来充气低压袖带,猫气道模拟器内的高容量气管导管。模拟器复制了平均大小的猫气管,用4.5毫米气管导管插管,连接到一个循环呼吸系统和压力控制通风与氧气和医疗空气。参与者为ETC充气:通过飞行员气球触诊(P);通过在机械通气过程中滴注气道泄漏损失所需的最小闭塞体积(MOV);直到使用阻力丧失注射器(LOR)被动释放压力;并使用带有数字压力读取器(D)的注射器,专门设计用于气管内袖带充气。通过对参与者进行模糊的压力计来测量内部压力。理想的压力被认为是在20和30cmH2O之间。数据由Shapiro-Wilk分析,Kruskal-Wallis和χ2检验,视情况而定。
参与者是八名兽医和两名兽医护士,他们接受了麻醉方面的额外培训。测得的P,MOV,LOR和D,分别,是25cmH2O(范围4-74cmH2O),41cmH2O(范围4-70cmH2O),31cmH2O(范围18-64cmH2O)和22cmH2O(范围20-30cmH2O)。D表现明显优于所有其他技术(P<0.001),与其他技术没有区别。
将D用于袖带充气实现了最佳袖带压力。使用P、MOV或LOR膨胀技术。因此,使用这些技术时,建议使用袖带压力计。