{"title":"体外循环下心脏手术中气管内套管压力变化的评价。","authors":"Alireza Mahoori, Shahriar Khanahmadi, Shima Khanahmadi, Nasim Parvin Karami, Peyman Mokhtarzadehazar","doi":"10.34172/jcvtr.2023.31733","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Tracheal intubation is used for most operations under general anesthesia. Prolonged hyperinflation of the tube cuff can compromise tracheal mucosal perfusion, and low pressure of the cuff may cause some other complications. The aim of this study was the evaluation of changes in intra-cuff pressure in patients undergoing cardiac surgeries under cardiopulmonary bypass. <b><i>Methods:</i></b> In an observational study 120 patient's candidate to cardiac operations under cardiopulmonary bypass were enrolled. After induction of anesthesia and tracheal intubation by same tracheal tubes, tracheal tube cuff pressure was adjusted to 20-25 mm Hg (T0). Then the cuff pressure was measured at beginning of CPB (Cardio Pulmonary Bypass) (T1), at 30º hypothermia (T2) and after separation from CPB (T3). <b><i>Results:</i></b> The mean cuff pressure was 33.5±7.3, 28.9±5.4, 25.6±5.2 and 28.1±3.7 at T0, T1, T2 and T3 respectively. Intra- cuff pressure changed significantly during cardiopulmonary bypass. <b><i>Conclusion:</i></b> The mean intra-cuff pressure was decreased during hypothermic cardiopulmonary bypass. The decrease in cuff pressure may protect the tracheal mucosa against hypotensive ischemic injury in these patients.</p>","PeriodicalId":15207,"journal":{"name":"Journal of Cardiovascular and Thoracic Research","volume":"15 1","pages":"51-56"},"PeriodicalIF":1.2000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278193/pdf/","citationCount":"1","resultStr":"{\"title\":\"Evaluation of the endotracheal tube cuff pressure changes during cardiac operations under cardiopulmonary bypass.\",\"authors\":\"Alireza Mahoori, Shahriar Khanahmadi, Shima Khanahmadi, Nasim Parvin Karami, Peyman Mokhtarzadehazar\",\"doi\":\"10.34172/jcvtr.2023.31733\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Introduction:</i></b> Tracheal intubation is used for most operations under general anesthesia. Prolonged hyperinflation of the tube cuff can compromise tracheal mucosal perfusion, and low pressure of the cuff may cause some other complications. The aim of this study was the evaluation of changes in intra-cuff pressure in patients undergoing cardiac surgeries under cardiopulmonary bypass. <b><i>Methods:</i></b> In an observational study 120 patient's candidate to cardiac operations under cardiopulmonary bypass were enrolled. After induction of anesthesia and tracheal intubation by same tracheal tubes, tracheal tube cuff pressure was adjusted to 20-25 mm Hg (T0). Then the cuff pressure was measured at beginning of CPB (Cardio Pulmonary Bypass) (T1), at 30º hypothermia (T2) and after separation from CPB (T3). <b><i>Results:</i></b> The mean cuff pressure was 33.5±7.3, 28.9±5.4, 25.6±5.2 and 28.1±3.7 at T0, T1, T2 and T3 respectively. Intra- cuff pressure changed significantly during cardiopulmonary bypass. <b><i>Conclusion:</i></b> The mean intra-cuff pressure was decreased during hypothermic cardiopulmonary bypass. The decrease in cuff pressure may protect the tracheal mucosa against hypotensive ischemic injury in these patients.</p>\",\"PeriodicalId\":15207,\"journal\":{\"name\":\"Journal of Cardiovascular and Thoracic Research\",\"volume\":\"15 1\",\"pages\":\"51-56\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278193/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cardiovascular and Thoracic Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.34172/jcvtr.2023.31733\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular and Thoracic Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.34172/jcvtr.2023.31733","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 1
摘要
简介:气管插管是全麻下大多数手术的常用方法。袖带长期的过度膨胀会损害气管粘膜灌注,而袖带的低压可能会引起一些其他并发症。本研究的目的是评估在体外循环下接受心脏手术的患者袖内压力的变化。方法:在一项观察性研究中,纳入了120例体外循环下心脏手术的候选者。诱导麻醉和气管插管相同气管插管后,调整气管套压至20 ~ 25 mm Hg (T0)。然后在CPB(心肺旁路)开始时(T1)、低温30º时(T2)和CPB分离后(T3)测量袖带压力。结果:T0、T1、T2、T3时平均袖带压力分别为33.5±7.3、28.9±5.4、25.6±5.2、28.1±3.7。体外循环过程中袖内压力变化明显。结论:低温体外循环降低了平均袖内压。袖带压力的降低可以保护气管黏膜免受低血压缺血性损伤。
Evaluation of the endotracheal tube cuff pressure changes during cardiac operations under cardiopulmonary bypass.
Introduction: Tracheal intubation is used for most operations under general anesthesia. Prolonged hyperinflation of the tube cuff can compromise tracheal mucosal perfusion, and low pressure of the cuff may cause some other complications. The aim of this study was the evaluation of changes in intra-cuff pressure in patients undergoing cardiac surgeries under cardiopulmonary bypass. Methods: In an observational study 120 patient's candidate to cardiac operations under cardiopulmonary bypass were enrolled. After induction of anesthesia and tracheal intubation by same tracheal tubes, tracheal tube cuff pressure was adjusted to 20-25 mm Hg (T0). Then the cuff pressure was measured at beginning of CPB (Cardio Pulmonary Bypass) (T1), at 30º hypothermia (T2) and after separation from CPB (T3). Results: The mean cuff pressure was 33.5±7.3, 28.9±5.4, 25.6±5.2 and 28.1±3.7 at T0, T1, T2 and T3 respectively. Intra- cuff pressure changed significantly during cardiopulmonary bypass. Conclusion: The mean intra-cuff pressure was decreased during hypothermic cardiopulmonary bypass. The decrease in cuff pressure may protect the tracheal mucosa against hypotensive ischemic injury in these patients.