MỐI LIÊN HỆ GIỮA ÁP LỰC ĐƯỜNG THỞ VÀ ÁP LỰC BÓNG CHÈN ỐNG NỘI KHÍ QUẢN TRONG PHẪU THUẬT NỘI SOI Ổ BỤNG

Abstract

Background: Although endotracheal tube (ETT) cuff pressure is adjusted within the safe range, increases in peak airway pressure caused by intraperitoneal CO₂ insufflation can elevate the ETT cuff pressure, thereby compromising tracheal mucosal perfusion and increasing the risk of postoperative complications.Objective: To determine the correlation between ETT cuff pressure and peak airway pressure, and related factors in laparoscopic surgery. Methods: A descriptive cross-sectional study conducted on patients undergoing laparoscopic surgery under general anesthesia and mechanical ventilation, using cuffed endotracheal tubes. Results: A total of 47 patients underwent laparoscopic surgery in the Trendelenburg position and 53 patients underwent laparoscopic surgery in the reverse Trendelenburg position were included in the study. After CO₂ insufflation, the ETT cuff pressure increased from a baseline of 25 cmH₂O to 31.3 ± 2 cmH₂O in the Trendelenburg group (p < 0.001) and to 30.6 ± 1.8 cmH₂O in the reverse Trendelenburg group (p < 0.001). The ETT cuff pressure continued to rise to 32.4 ± 2.6 cmH₂O following the change to the Trendelenburg position (p = 0.03), whereas no significant difference was observed with the reverse Trendelenburg position (p > 0.05). At the time of CO₂ insufflation, the increase in peak airway pressure positively correlated with the increase in ETT cuff pressure, with a correlation coefficient of r = 0.5 (p < 0.001). Conclusion: There was a statistically significant increase in ETT cuff pressure following CO₂ insufflation and Trendelenburg position transition. Although the ETT cuff pressure was adjusted within the safe range, the elevated peak airway pressure was still transmitted to the ETT cuff, leading to an increase in cuff pressure.