低温对先天性心脏病患儿体外循环期间气管导管套囊压力的影响

Effect of hypothermia on endotracheal tube cuff pressure during cardiopulmonary bypass in pediatric patients with congenital heart disease

目的评价低温对先天性心脏病患儿体外循环期间气管导管套囊压力的影响.方法择期在体外循环下行先天性心脏病矫治术的患儿40例,性别不限,ASA分级Ⅱ-Ⅳ级,年龄1月~14岁,体重3~58kg.患儿均采用带套囊的气管导管进行气管插管术.麻醉诱导气管插管后向套囊内注入空气,监测并调节套囊压力至20cmH2O(基础状态).分别于食道温度降至34、32、30、28、28℃以下和复温至28、30、32、34、36℃时,记录气管导管套囊压力.结果与基础状态相比,患儿食道温度降至30、28、28℃以下和复温至28、30、32、34℃时气管导管套囊压力显著降低(P<0.05).结论低温可降低先天性心脏病患儿体外循环期间气管导管套囊压力,建议常规监测套囊压力.

Objective To evaluate the effect of hypothermia on the endotracheal tube cuff pressure during cardiopulmonary bypass in the pediatric patients with congenital heart disease.Methods Forty pediatric patients of both sexes,of American Society of Anesthesiologists physical statusⅡ–Ⅳ,aged 1 months–14 yr,weighing 3–58 kg,scheduled for elective surgery for congenital heart disease using cardiopulmonary bypass,were included in this study.All the pediatric patients were intubated with a cuffed endotracheal tube.After anesthesia induction and endotracheal intubation,the air was injected into the cuff to make the cuff pressure reach 20 cm H2O(baseline).The endotracheal tube cuff pressure was recorded when the esophageal temperature was reduced to 34,32,30,28 and below 28℃and returned to 28,30,32,34 and 36℃.Results The cuff pressure was significantly decreased when the esophageal temperature was reduced to 30 and 28℃and below 28℃and returned to 28,30,32 and 34℃as compared with the baseline(P<0.05).Conclusion Hypothermia can reduce the endotracheal tube cuff pressure during cardiopulmonary bypass,and it is recommended to routinely monitor the cuff pressure in the pediatric patients with congenital heart disease.