KHẢO SÁT ÁP LỰC BÓNG CHÈN ỐNG NỘI KHÍ QUẢN TRONG GÂY MÊ NỘI KHÍ QUẢN

Abstract

Background: In clinical practice, endotracheal tube cuff pressure during endotracheal anesthesia is often not measured. Cuff pressure is often based on palpation and experience of the person pumping the cuff. Cuff pressure above 30 cmH2O can damage the tracheal mucosa and cause many complications for intubated patients. However, this factor can be avoided with the attention and management of anesthesiologists. Ojectives: To evaluate the rate and predictors of cuff pressure exceeding the safe threshold in patients undergoing endotracheal anesthesia. Methods: A prospective, cross-sectional study was performed on 122 patients undergoing endotracheal anesthesia for elective surgery. Immediately after the patients were intubated, the cuff pressure was measured, recorded and adjusted if it was outside the safe range. Parameters of cuff pressure, volume of gas pumped into the cuff, and endotracheal tube size were recorded and analyzed. Results: Mean cuff pressure with palpation technique was 32±10.6 cmH₂O. The rate of cuff pressure exceeding 30 cmH2O is 41.8%. There were 12 cases of cuff pressure greater than 50 cmH₂O. Independent factors predicting cuff pressure exceeding the safe threshold include short height (OR = 0.68, 95% CI: 0.5 - 0.9, p = 0.009), volume of air pumped into the cuff  (OR = 31.53, 95% CI: 5.39 – 184.54, p=0.001). Conclusion: Cuff pressure cannot reach a value within the safe threshold by palpation technique so endotracheal tube cuff pressure should routinely be measured using a manometer. It is necessary to choose the appropriate endotracheal tube size for each patient.