Background: Maintenance of optimal Endotracheal Tube cuff Pressure (ETTcP) in anaesthetic practice reduces cuff pressure complications. Aneroid manometers for measurement of ETTcP are not widely available in Ghana, he...Background: Maintenance of optimal Endotracheal Tube cuff Pressure (ETTcP) in anaesthetic practice reduces cuff pressure complications. Aneroid manometers for measurement of ETTcP are not widely available in Ghana, hence anaesthesia providers estimate ETTcP according to their experience. The study assessed ETTcP obtained from estimation techniques between anaesthesia providers at Korle-Bu Teaching Hospital (KBTH). It also evaluated the Volume of Air Required (VAR) to obtain an acceptable cuff inflation pressure for sizes 7.0 and 8.0 mm adult endotracheal tubes used at the hospital, and the effect of patient’s age, weight and height on this volume. Methods: Eighty-one patients who underwent general anaesthesia were recruited. ETTcP was measured using an aneroid manometer via a three-way tap. After full cuff deflation, the cuff was refilled with air until an ETTcP of 20 cm H2O was obtained. Independent t-test was used to measure the statistical variations in the ETTcP using estimation techniques in relation to recommended levels as well as the significant difference of mean VAR to obtain a cuff pressure of 20 cm H2O. Grouped t-test was used to determine significant differences in ETTcP between anaesthesia providers using estimation techniques. Results: Mean ETTcP obtained from estimation techniques was (61.87, 73.79) cm H2O. The mean ETTcP measured for Physician and Nurse Anaesthetists were 65.36 cm H20 and 69.52 cm H2O respectively. The mean VAR to achieve an ETTcP of 20 cm H2O for endotracheal tube sizes 7.0 mm and 8.0 mm were 3.90 ± 1.13 mls and 4.55 ± 0.95 mls respectively. Age and weight significantly influenced the VAR to achieve a cuff pressure of 20 cm H2O, however, height did not. Conclusions: This study demonstrated that cuff pressures obtained by estimation techniques were generally higher than the recommended average with no significant difference between anaesthesia providers. However, in the absence of an aneroid manometer, ETTcP of tube sizes 7.0 mm and 8.0 mm can be safely approximated to the recommended levels with predetermined inflation volumes.展开更多
BACKGROUND The proper cuff pressure of endotracheal tube(ET)plays an important role in sealing the airway and preventing airway complications during mechanical ventilation.The ET cuff shape affects the cuff pressure a...BACKGROUND The proper cuff pressure of endotracheal tube(ET)plays an important role in sealing the airway and preventing airway complications during mechanical ventilation.The ET cuff shape affects the cuff pressure after positional change.AIM To investigate cuff pressure between tapered and cylindrical cuff after extension of head and neck during nasal endotracheal intubation.METHODS In a randomized clinical trial,52 patients were randomized to one of two groups:cylindrical cuff or Tapered cuff.Cuff pressure with 22 cmH_(2)O was applied to patients in the neutral position.After extension of head and neck,the cuff pressure was evaluated again and readjusted to 22 cmH_(2)O.In addition,the extent of cephalad migration of ET tip was assessed and postoperative airway complications such as sore throat,and hoarseness were measured.RESULTS The cuff pressure was higher in the tapered cuff(28.7±1.0 cmH_(2)O)than in the cylindrical cuff(25.5±0.8 cmH_(2)O)after head and neck extension(P<0.001).The extent of cephalad migration of tube tip was greater in TaperGuard ET(18.4±2.2 mm)than in conventional ET(15.1±1.2 mm)(P<0.001).The incidence of postoperative airway complications was comparable between two groups.CONCLUSION After head and neck extension,the cuff pressure and the extent of cephalad migration of ET was greater in tapered cuff than in cylindrical cuff during nasal intubation,respectively.展开更多
We agree with the editorial published by Feng et al concerning the insufficient routine monitoring of tracheal tube cuff pressure(TTCP) by anesthesiologists, and propose an improvised technique that can facilitate and...We agree with the editorial published by Feng et al concerning the insufficient routine monitoring of tracheal tube cuff pressure(TTCP) by anesthesiologists, and propose an improvised technique that can facilitate and promote such routine monitoring by intensive care staff who attend to patients receiving mechanical ventilation. Insufficient monitoring of tracheal cuff pressure has also been documented for intensive care unit nurses. Measurements of cuff pressure are beneficial when used in management of air leakage around an endotracheal tube, and can be easily obtained with the aid of a personalized and simple technique performed using materials that are readily available in all hospitals. Other investigators have previously demonstrated the usefulness of employing an improvised technique. We considered that possible disadvantages are similar to those encountered when using standardized equipment. With our improvised technique, we seek to promote among the nursing staff the determination of the TTCP in intubated patients to reduce the risk of related medical complications.展开更多
目的探讨麻醉专业住院医师规范化培训医师使用数字压力表进行气管导管气囊充气触感训练的培训效果。方法选择2021年6—9月滨州医学院附属医院的麻醉专业住院医师规范化培训(简称“住培”)医师44名,按照随机数字表法,分为试验组和对照组...目的探讨麻醉专业住院医师规范化培训医师使用数字压力表进行气管导管气囊充气触感训练的培训效果。方法选择2021年6—9月滨州医学院附属医院的麻醉专业住院医师规范化培训(简称“住培”)医师44名,按照随机数字表法,分为试验组和对照组,每组22名。试验组住培医师在数字压力表指导下进行正确压力范围内的气管导管气囊充气,对照组住培医师使用传统的主观触感法进行气囊充气。两组住培医师均采用主观触感法进行气囊充气,使用数字压力表测量两组住培医师的气囊充气压力情况。分析测试阶段的两组气囊压力情况、两组患者术后咽痛的发生率及住培医师对此次培训的满意度。结果两组患者的美国麻醉医师协会健康状况分级(American Society of Anesthesiologists,ASA)及机械通气时间比较无统计学差异(P<0.05)。在试验组患者气囊压力低于对照组患者气囊压力,差异有统计学意义(P<0.05);试验组患者术后咽痛发生率低于对照组,差异有统计学意义(P<0.05)。试验组住培医师对此次培训的满意度更高,差异有统计学意义(P<0.05)。结论使用数字压力表训练麻醉专业住培医师气囊充气的触感,培养正确气囊压力范围内的主观感觉,减少麻醉相关并发症,有利于提高培训质量和教学满意度。展开更多
文摘Background: Maintenance of optimal Endotracheal Tube cuff Pressure (ETTcP) in anaesthetic practice reduces cuff pressure complications. Aneroid manometers for measurement of ETTcP are not widely available in Ghana, hence anaesthesia providers estimate ETTcP according to their experience. The study assessed ETTcP obtained from estimation techniques between anaesthesia providers at Korle-Bu Teaching Hospital (KBTH). It also evaluated the Volume of Air Required (VAR) to obtain an acceptable cuff inflation pressure for sizes 7.0 and 8.0 mm adult endotracheal tubes used at the hospital, and the effect of patient’s age, weight and height on this volume. Methods: Eighty-one patients who underwent general anaesthesia were recruited. ETTcP was measured using an aneroid manometer via a three-way tap. After full cuff deflation, the cuff was refilled with air until an ETTcP of 20 cm H2O was obtained. Independent t-test was used to measure the statistical variations in the ETTcP using estimation techniques in relation to recommended levels as well as the significant difference of mean VAR to obtain a cuff pressure of 20 cm H2O. Grouped t-test was used to determine significant differences in ETTcP between anaesthesia providers using estimation techniques. Results: Mean ETTcP obtained from estimation techniques was (61.87, 73.79) cm H2O. The mean ETTcP measured for Physician and Nurse Anaesthetists were 65.36 cm H20 and 69.52 cm H2O respectively. The mean VAR to achieve an ETTcP of 20 cm H2O for endotracheal tube sizes 7.0 mm and 8.0 mm were 3.90 ± 1.13 mls and 4.55 ± 0.95 mls respectively. Age and weight significantly influenced the VAR to achieve a cuff pressure of 20 cm H2O, however, height did not. Conclusions: This study demonstrated that cuff pressures obtained by estimation techniques were generally higher than the recommended average with no significant difference between anaesthesia providers. However, in the absence of an aneroid manometer, ETTcP of tube sizes 7.0 mm and 8.0 mm can be safely approximated to the recommended levels with predetermined inflation volumes.
文摘BACKGROUND The proper cuff pressure of endotracheal tube(ET)plays an important role in sealing the airway and preventing airway complications during mechanical ventilation.The ET cuff shape affects the cuff pressure after positional change.AIM To investigate cuff pressure between tapered and cylindrical cuff after extension of head and neck during nasal endotracheal intubation.METHODS In a randomized clinical trial,52 patients were randomized to one of two groups:cylindrical cuff or Tapered cuff.Cuff pressure with 22 cmH_(2)O was applied to patients in the neutral position.After extension of head and neck,the cuff pressure was evaluated again and readjusted to 22 cmH_(2)O.In addition,the extent of cephalad migration of ET tip was assessed and postoperative airway complications such as sore throat,and hoarseness were measured.RESULTS The cuff pressure was higher in the tapered cuff(28.7±1.0 cmH_(2)O)than in the cylindrical cuff(25.5±0.8 cmH_(2)O)after head and neck extension(P<0.001).The extent of cephalad migration of tube tip was greater in TaperGuard ET(18.4±2.2 mm)than in conventional ET(15.1±1.2 mm)(P<0.001).The incidence of postoperative airway complications was comparable between two groups.CONCLUSION After head and neck extension,the cuff pressure and the extent of cephalad migration of ET was greater in tapered cuff than in cylindrical cuff during nasal intubation,respectively.
文摘We agree with the editorial published by Feng et al concerning the insufficient routine monitoring of tracheal tube cuff pressure(TTCP) by anesthesiologists, and propose an improvised technique that can facilitate and promote such routine monitoring by intensive care staff who attend to patients receiving mechanical ventilation. Insufficient monitoring of tracheal cuff pressure has also been documented for intensive care unit nurses. Measurements of cuff pressure are beneficial when used in management of air leakage around an endotracheal tube, and can be easily obtained with the aid of a personalized and simple technique performed using materials that are readily available in all hospitals. Other investigators have previously demonstrated the usefulness of employing an improvised technique. We considered that possible disadvantages are similar to those encountered when using standardized equipment. With our improvised technique, we seek to promote among the nursing staff the determination of the TTCP in intubated patients to reduce the risk of related medical complications.
文摘目的探讨麻醉专业住院医师规范化培训医师使用数字压力表进行气管导管气囊充气触感训练的培训效果。方法选择2021年6—9月滨州医学院附属医院的麻醉专业住院医师规范化培训(简称“住培”)医师44名,按照随机数字表法,分为试验组和对照组,每组22名。试验组住培医师在数字压力表指导下进行正确压力范围内的气管导管气囊充气,对照组住培医师使用传统的主观触感法进行气囊充气。两组住培医师均采用主观触感法进行气囊充气,使用数字压力表测量两组住培医师的气囊充气压力情况。分析测试阶段的两组气囊压力情况、两组患者术后咽痛的发生率及住培医师对此次培训的满意度。结果两组患者的美国麻醉医师协会健康状况分级(American Society of Anesthesiologists,ASA)及机械通气时间比较无统计学差异(P<0.05)。在试验组患者气囊压力低于对照组患者气囊压力,差异有统计学意义(P<0.05);试验组患者术后咽痛发生率低于对照组,差异有统计学意义(P<0.05)。试验组住培医师对此次培训的满意度更高,差异有统计学意义(P<0.05)。结论使用数字压力表训练麻醉专业住培医师气囊充气的触感,培养正确气囊压力范围内的主观感觉,减少麻醉相关并发症,有利于提高培训质量和教学满意度。
