The Effect of Different Body Positions on Endotracheal Tube Cuff Pressure in Patients under Mechanical Ventilation

Amir Jalali, Z. Maleki, M. Dinmohammadi
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Abstract

Introduction: Maintaining endotracheal tube intracuff pressure (ETTICP) within an optimal range is crucial for effective ventilation and prevention of aspiration. This study aimed to determine the effect of changing body position on ETTICP in patients under mechanical ventilation. Methods: In the current single-group study, each patient was taken as his/her own control. Thirty patients who met the inclusion criteria were selected as the study sample. First, the patients were placed in a supine (flat) position, head of the bed was raised to 30 degrees, and ETTICP was set at 25 cmH2 O as the baseline. Then, the ETTICP changes in the three positions (left lateral, right lateral, and semi-fowler) were compared with the baseline. Interventions were made on a random basis among the patients. Data were analyzed by repeated-measures ANOVA using SPSS version 13. Results: There was a significant difference among ETTICP means in three different body positions, so that ETTICP was higher in the left lateral position compared to other positions. Moreover, there was a significant difference among ETTICP means 0, 15, 45, and 90 minutes after changing the body position. ETTICP means after 0 and 15 minutes were significantly higher than other times compared to the baseline. Conclusion: ETTICP changes were affected by different body positions and the passage of time. Thus, regular monitoring and adjusting of ETTICP after any body positioning is essential, especially immediately and 15 minutes after repositioning.
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机械通气患者不同体位对气管插管袖带压力的影响
导读:将气管插管内压(ETTICP)维持在最佳范围内对于有效通气和预防误吸至关重要。本研究旨在探讨体位改变对机械通气患者ETTICP的影响。方法:在目前的单组研究中,每个患者作为自己的对照。选取符合纳入标准的30例患者作为研究样本。首先,将患者置于仰卧位(平卧位),将床头抬高至30度,将ETTICP设为25 cmh2o作为基线。然后,将三个体位(左侧、右侧和半fowler)的ETTICP变化与基线进行比较。干预是在随机的基础上进行的。数据采用SPSS version 13重复测量方差分析。结果:三种体位的ETTICP均值有显著性差异,左侧体位的ETTICP高于其他体位。体位改变后0、15、45、90分钟的ETTICP平均值差异有统计学意义。与基线相比,0和15分钟后的ETTICP显著高于其他时间。结论:ETTICP的变化受不同体位和时间的影响。因此,在任何体位后,定期监测和调整ETTICP是必要的,特别是在重新体位后立即和15分钟。
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