关键词: 通气机, 机械, 肺炎, 呼吸机相关性, 直接测压, 间接测压, 锥形套囊, 柱形套囊

Abstract:

Objective To compare the sealing effects of direct and indirect pressure measurement methods on cuffs with taper and columnar shapes. Methods Cuffs were divided into the taper and columnar shapes,both groups were measured using direct and indirect measurement procedures,and the fluid leakage of two groups were observed. The direct measurement method monitored pressure by a directly linked handheld pressure gauge,while the indirect measurement method added a 3-way stopcock between the handheld pressure gauge and the cuff. We locked the 3-stopcock to stabilize handheld pressure gauge reading at 32 cmH₂O before measure the pressure. Results The pressure of the taper shaped cuffs in direct measurement group was（21.73±0.30） cmH₂O while the pressure of column shaped cuffs was（25.01±0.13） cmH₂O,which showed a statistically significant difference （P<0.01）. Fluid on the two types of cuffs all leaked after direct measurement. The pressure of the taper shaped cuffs in indirect measurement group was（31.08±0.31） cmH₂O,and（31.10±0.17） cmH₂O in columnar shape,without significant difference（P>0.05）. Fluid on the taper shaped cuffs didn’t leak after indirect measurement procedures yet the fluid on column shaped cuffs all leaked. Conclusion The direct measurement method can cause pressure decreasing in taper and column shaped cuffs as well as fluid leakage. Indirect measurement method can lose only 1~2 cmH₂O of pressure for taper and column shaped cuffs,and the taper shaped cuffs can seal fluid leak effectively.

Key words: Ventilators, Mechanical, Pneumonia, Ventilator-Associated, Direct Pressure Measurement, Indirect Pressure Measurement, Taper-Shaped Cuff, Column-Shaped Cuff