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首页> 外文期刊>BMC Anesthesiology >Measurement of endotracheal tube secretions volume by micro computed tomography (MicroCT) scan: an experimental and clinical study
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Measurement of endotracheal tube secretions volume by micro computed tomography (MicroCT) scan: an experimental and clinical study

机译：微型计算机断层扫描（MicroCT）扫描测量气管内插管分泌量的实验和临床研究

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Background Biofilm accumulates within the endotracheal tube (ETT) early after intubation. Contaminated secretions in the ETT are associated with increased risk for microbial dissemination in the distal airways and increased resistance to airflow. We evaluated the effectiveness of micro computed tomography (MicroCT) for the quantification of ETT inner volume reduction in critically ill patients. Methods We injected a known amount of gel into unused ETT to simulate secretions. We calculated the volume of gel analyzing MicroCT scans for a length of 20?cm. We then collected eleven ETTs after extubation of critically ill patients, recording clinical and demographical data. We assessed the amount of secretions by MicroCT and obtained ETT microbiological cultures. Results Gel volumes assessed by MicroCT strongly correlated with injected gel volumes (p?2?=?0.999). MicroCT revealed the accumulation of secretions on all the ETTs (median 0.154, IQR:0.02-0.837?mL), corresponding to an average cross-sectional area reduction of 1.7%. The amount of secretions inversely correlated with patients’ age (p?=?0.011, rho?=??0.727) but not with days of intubation, SAPS2, PaO2/FiO2 assessed on admission. Accumulation of secretions was higher in the cuff region (p?=?0.003). Microbial growth occurred in cultures from 9/11 ETTs, and did not correlate with secretions amount. In 7/11 cases the same microbes were identified also in tracheal aspirates. Conclusions MicroCT appears as a feasible and precise technique to measure volume of secretions within ETTs after extubation. In patients, secretions tend to accumulate in the cuff region, with high variability among patients.
机译：背景气管插管后早期，生物膜积聚在气管内导管（ETT）中。 ETT中受污染的分泌物与远端呼吸道中微生物传播的风险增加以及对气流的阻力增加有关。我们评估了微计算机断层扫描（MicroCT）量化危重患者ETT内部容积减少的有效性。方法我们向未使用的ETT中注入已知量的凝胶以模拟分泌。我们计算了长度为20？cm的凝胶分析MicroCT扫描的体积。然后我们在危重病人拔管后收集了11个ETT，记录了临床和人口统计学数据。我们通过MicroCT评估了分泌物的量，并获得了ETT微生物培养物。结果通过MicroCT评估的凝胶体积与注射的凝胶体积紧密相关（p≥2α＝≥0.999）。 MicroCT显示所有ETT上都有分泌物积聚（中位数0.154，IQR：0.02-0.837？mL），相当于平均截面积减少了1.7％。分泌量与患者年龄成反比（p = 0.011，rho = 0.727），而与插管天数，SAPS2，PaO 2 / FiO 2 无关。 sub>入学时评估。在袖带区域分泌物的积累较高（p≥0.003）。从9/11 ETT开始的培养物中发生了微生物生长，并且与分泌量无关。在7/11例中，在气管吸出物中也鉴定出相同的微生物。结论MicroCT似乎是一种可行且精确的技术，可用于测量拔管后ETT内的分泌量。在患者中，分泌物倾向于在袖带区域积聚，患者之间差异很大。

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