Abstract：
OBJECTIVE: Gas leakage around the cuff of a tracheal tube may frequently occur after tracheal intubation and inflation of the cuff. We assessed if the SmartCuff (Smiths Medical Japan, Tokyo, Japan), an automatic cuff pressure controller, would effectively prevent gas leakage.
METHODS: Seventy adult patients were allocated randomly to one of two groups. After induction of general anesthesia and tracheal intubation, in one group (Syringe group), a syringe was used to inflate the cuff, until there was no audible gas leakage, at the airway pressure at 20 cmH2O. In the other group (SmartCuff group), the SmartCuff was used to maintain the cuff pressure to be 20 cmH2O. The mechanical ventilation (tidal volume of 8 ml.kg-1 and 12 breaths per min) was started. The incidence and percentage of gas leakage, and the proportion of adequate seal (defined as gas leakage of < 10%) between the groups were compared.
RESULTS: The incidence of audible gas leakage was significantly higher in the Syringe group (10 of 35 patients (28%)) than in the SmartCuff group (none of 35 patients (0%)) (P = 0.00046, 95%CI for difference: 15-43%), and the proportion of adequate seal was significantly lower in the Syringe group (19 of 35 patients (54%)) than in the Smart cuff group (33 of 35 patients (94%)) (P = 0.0001, 95% CI for difference: 20-58%).
CONCLUSIONS: Gas leakage may frequently occur after tracheal intubation, and the use of the SmartCuff can effectively maintain the sealing effect of the cuff.
METHODS: Seventy adult patients were allocated randomly to one of two groups. After induction of general anesthesia and tracheal intubation, in one group (Syringe group), a syringe was used to inflate the cuff, until there was no audible gas leakage, at the airway pressure at 20 cmH2O. In the other group (SmartCuff group), the SmartCuff was used to maintain the cuff pressure to be 20 cmH2O. The mechanical ventilation (tidal volume of 8 ml.kg-1 and 12 breaths per min) was started. The incidence and percentage of gas leakage, and the proportion of adequate seal (defined as gas leakage of < 10%) between the groups were compared.
RESULTS: The incidence of audible gas leakage was significantly higher in the Syringe group (10 of 35 patients (28%)) than in the SmartCuff group (none of 35 patients (0%)) (P = 0.00046, 95%CI for difference: 15-43%), and the proportion of adequate seal was significantly lower in the Syringe group (19 of 35 patients (54%)) than in the Smart cuff group (33 of 35 patients (94%)) (P = 0.0001, 95% CI for difference: 20-58%).
CONCLUSIONS: Gas leakage may frequently occur after tracheal intubation, and the use of the SmartCuff can effectively maintain the sealing effect of the cuff.
摘要：
目的：气管插管和袖带充气后，气管导管袖带周围的气体泄漏可能经常发生。我们评估了SmartCuff(SmithsMedicalJapan,东京,Japan),自动袖带压力控制器，能有效防止气体泄漏。
方法：将70例成年患者随机分为两组。全麻诱导和气管插管后，一组（注射器组），用注射器给袖口充气,直到没有气体泄漏的声音,在20cmH2O的气道压力下。在另一组（SmartCuff组）中，SmartCuff用于维持袖带压力为20cmH2O。机械通气(潮气量8ml。开始kg-1和每分钟12次呼吸）。气体泄漏的发生率和百分比，并比较各组间充分密封的比例(定义为漏气量<10%)。
结果：注射器组（35例患者中有10例（28％））的可听气体泄漏发生率明显高于SmartCuff组（35例患者中没有一例（0％））（P=0.00046，95CI，差异：15-43％），注射器组(35例患者中的19例(54%))的充分密封比例显著低于Smart袖带组(35例患者中的33例(94%))(P=0.0001,95%CI:20-58%)。
结论：气管插管后可能经常发生漏气，并且使用SmartCuff可以有效地保持袖带的密封效果。
方法：将70例成年患者随机分为两组。全麻诱导和气管插管后，一组（注射器组），用注射器给袖口充气,直到没有气体泄漏的声音,在20cmH2O的气道压力下。在另一组（SmartCuff组）中，SmartCuff用于维持袖带压力为20cmH2O。机械通气(潮气量8ml。开始kg-1和每分钟12次呼吸）。气体泄漏的发生率和百分比，并比较各组间充分密封的比例(定义为漏气量<10%)。
结果：注射器组（35例患者中有10例（28％））的可听气体泄漏发生率明显高于SmartCuff组（35例患者中没有一例（0％））（P=0.00046，95CI，差异：15-43％），注射器组(35例患者中的19例(54%))的充分密封比例显著低于Smart袖带组(35例患者中的33例(94%))(P=0.0001,95%CI:20-58%)。
结论：气管插管后可能经常发生漏气，并且使用SmartCuff可以有效地保持袖带的密封效果。
