-测气管内导管套囊压力的注射器的设计和体外测试.docVIP

测量气管内?导管套囊压?力的注射器?外验证测试? Alexa?nder H. Slocu?m, Jr., SM,* Alexa?nder H. Slocu?m, Sr., PhD,* and Joan E. Spieg?el, MD? *Depar?tment? of Mecha?nical? Engin?eerin?g, Massa?chuse?tts Insti?tute of Techn?ology?, Cambr?idge; and ?Depar?tment? of Anest?hesia?, Criti?cal Care and Pain Medic?ine, Beth Israe?l Deaco?ness Medic?al Cente?r, Bosto?n, Massa?chuse?tts 摘要 气管内插管?是在对入院?前急救、重症监护病?房和手术患?者经常实施?的一种操作?。气管导管的?套囊需要充?气到一定的?压力以防漏?气，同时还需保?证气管粘膜?的血流不受?影响。为了能够在?给套囊充气?的同时测定?其压力，我们设计了?一种新型的?测量压力的?注射器，并进行了体?外测试。其原型就是?一个标准的?10 ml聚碳酸?/偏离），差在0.3 ~ 1.61 cm（误差为1%-5%）。与无液压力?计相比，在30 mm H2O以内?Spear?man等级?0.99P ＜0.001）。 Abstr?act Endot?rache?al intub?ation? is a frequ?ently? perfo?rmed proce?dure in the preho?spita?l setti?ng,inten?sive care unit, and for patie?nts under?going? surge?ry. The endot?rache?al tube cuff must be infla?ted to a press?ure that preve?nts air leaks? witho?ut compr?omisi?ng trach?eal mucos?al blood? flow. For simul?taneo?us endot?rache?al tube cuff infla?tion and measu?remen?t, we desig?ned and teste?d a novel? press?ure-sensi?ng syrin?ge in vitro?. The proto?type was devel?oped using? a stand?ard 10-mL polyc?arbon?ate syrin?ge body that house?s a plung?er and a silic?one rubbe?r bello?ws, the press?ure-sensi?ng eleme?nt. Bello?w feasi?bilit?y was deter?mined? and model?ed using? finit?e eleme?nt analy?sis. Repea?tabil?ity testi?ng at each press?ure measu?remen?t for each bello?ws (press?ure versu?s defle?ction?) was withi?n an avera?ge stand?ard devia?tion of 0.3 cm to 1.61 cm (1%–5% error?). Using? an anero?id manom?eter for compa?rison?, there? was excel?lent linea?r corre?latio?n with a Spear?man rank of 0.99 ( P＜0.001), up to 30 cm H2O. (Anest?h Analg? 2012;114:967–71) 自1919?30世纪3?年以来，有关气管内?导管（ETT）套囊过度充?气引起气道?并发症的文?献就相继发?表[1]。在19世纪?80年代，内镜研究表?明，套囊对气道?粘膜的压力?在28 ~ 34 cm H2O之间?50 cm H2O时，气道血流完?全被阻断[2]。入院前急救?成人患者中?ETT套囊?30 cm H2O）的情况超过?65%[3]，手术室内超?过50%[4]，重症监护病?房超过40?%[5]。即使在短小?手术中（1 ~ 3小时），过度充气的?ETT套囊?6-8]。相反，成人ETT?套囊充气不?足（ 20 cm H2O），对长期气管?插管的患者?会导致定植?下呼吸道气?