■气管内套囊压力(ETCP)是确定与有创机械通气相关的并发症发展的重要因素。为避免因固定而产生可预防的并发症,身体定位的频繁变化是必要的。身体位置的这种变化会影响机械通气的重症患者的ETCP。所以,本研究旨在评估机械通气患者体位变化对ETCP的影响.
■这项前瞻性观察性研究包括31名危重患者。首先将每个研究对象放置在中立的起始位置,头部高度为30º。然后,作为重症监护病房(CCU)日常工作的一部分,他们根据16个最常用的体位顺序改变体位.每次改变后测量气管内套囊压力。使用标准统计检验分析数据。
■在颈部前屈期间观察到ETCP的统计学显着差异,颈部过度伸展,颈部左外侧屈,颈部右外侧屈,颈部左侧旋转,颈部右侧旋转,10卧位,仰卧位,特伦德伦堡位置,和右侧30°和45°位置。在颈部前屈期间,可以看到ETCP的最大增加(31±4.5;22-42cmH2O)。
■我们的研究表明,在机械通气患者的身体位置变化后,ETCP与推荐范围存在显着偏差,强调了ETCP测量后的每个位置变化和保持在目标范围内的必要性。
■RoyO,DasguptaS,钱德拉A,BiswasP,乔杜里A,GhoshS,etal.重症患者机械通气时气管内套管压力与体位变化的关系:一项观察性研究。印度J暴击护理中心2024;28(1):36-40。
UNASSIGNED: Endotracheal tube cuff pressure (ETCP) is an important factor to determine the development of complications associated with invasive mechanical ventilation. To avoid preventable complications arising out of immobilization, frequent changes in body positioning are necessary. Such variations in body position can affect ETCP in critically ill patients who are on mechanical ventilation. So, our study aimed to assess the effect of changes in body position on ETCP in patients who are on mechanical ventilation.
UNASSIGNED: This prospective observational study included 31 critically ill intubated patients. Each study subject was first placed in a neutral starting position with a 30º head elevation. Then, they were subjected to a sequential change in body position based on the 16 most used positions as part of the critical care unit\'s (CCUs) daily routine. Endotracheal tube cuff pressure was measured after each position change. Data were analyzed using standard statistical tests.
UNASSIGNED: Statistically significant difference in ETCP was observed during anteflexion of neck, hyperextension of neck, left lateral flexion of neck, right lateral flexion of neck, left lateral rotation of neck, right lateral rotation of neck, 10o recumbent position, supine position, Trendelenburg position, and right lateral 30° and 45° positions. Maximum increase in ETCP was seen during anteflexion of neck (31 ± 4.5; 22-42 cm H2O).
UNASSIGNED: Our study demonstrates significant deviations in ETCP from the recommended range following changes in the body position of mechanically ventilated patients, highlighting the need for the measurement of ETCP after each position change and maintenance of the same within the target range.
UNASSIGNED: Roy O, Dasgupta S, Chandra A, Biswas P, Choudhury A, Ghosh S, et al. Relationship of Endotracheal Tube Cuff Pressures with Changes in Body Positions of Critically Ill Patients on Mechanical Ventilation: An Observational Study. Indian J Crit Care Med 2024;28(1):36-40.