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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Accuracy of the minimal leak test for endotracheal cuff pressure monitoring
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Accuracy of the minimal leak test for endotracheal cuff pressure monitoring

机译：气管内袖带压力监测最小泄漏试验的准确性

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Objectives To determine the accuracy of the minimum leak test as a surrogate for target endotracheal cuff pressure of 20–30 cm H 2 O in intubated patients. Methods Cuff pressures were measured at the University of Miami Hospital using the minimum leak test on every intubated patient once per shift, then cuff pressure was reevaluated using handheld numerical manometers and recorded pressures above or below the target range, readjusting the pressure as needed. This assessment was repeated throughout each patient's intubation for up to 6?days. The readjustment rate of the test and the probability of a patient needing at least one adjustment were determined. Results One hundred twenty‐two patients were evaluated. Median age was 67?years (range 29–95), 52% were male, 48% were female. Patients were followed for an average of 4.7?days. Seven hundred twenty‐two minimum leak tests were performed. Of these, 170 required readjustment into the target range (24% readjustment rate). Of the tests outside target range, 66% of cuffs were overinflated and 34% were underinflated. Fifty‐five percent of patients required at least one adjustment. Conclusion Despite ubiquitous use of the minimum leak test for endotracheal cuff pressure adjustment, the test has an unacceptably high error rate resulting in cuff pressures above or below the target range. Most patients will require at least one adjustment throughout an intubation, putting them at risk for tracheal injury, stenosis, or leak and aspiration. The minimum leak test is not sufficiently accurate for endotracheal cuff pressure monitoring. Formal manometry is superior and should be used to optimize patient outcomes. Level of Evidence 4 Laryngoscope , 130:1646–1650, 2020
机译：目的为确定最小泄漏测试的准确性为20-30厘米H 2ö插管患者的气管内目标袖带压力的替代。使用最小泄漏测试每个插管患者每一次换档在迈阿密大学医院测定方法袖带压，然后袖带压力，使用手持数字压力计和高于或低于目标范围的压力记录的重新评估，根据需要重新调整的压力。重复此整个评估每个患者的插管时间长达6天半。测试的调整率和患者需要至少一个调整的概率进行了测定。结果共22例患者进行了评价。平均年龄为67？年（29-95），52％为男性，48％为女性。患者平均随访4.7？天。七百22最低渗漏试验进行。在这些中，170需要重新调整到目标范围（24％调整率）。目标范围之外的测试，袖口的66％被过度充气和34％的充气不足。患者的百分之五十五，至少需要一个调整。结论尽管普遍使用的最小泄漏测试的气管袖带压的调整，该测试具有导致在目标范围内的上方或下方袖带压不可接受的高错误率。大多数患者至少需要一个调整整个插管，使他们在危险中为气管损伤，狭窄，或泄漏和愿望。最小泄漏测试不是气管袖带压力监测足够精确。正式测压优异，且应被用于优化患者的治疗效果。证据4喉镜的水平，130：1646至50年2020年

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