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首页> 外文期刊>Anaesthesia and intensive care >Effects of prolonged mechanical ventilation with a closed suction system on endotracheal tube resistance and its reversibility by a closed suction cleaning system
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Effects of prolonged mechanical ventilation with a closed suction system on endotracheal tube resistance and its reversibility by a closed suction cleaning system

机译：封闭式抽吸系统长时间机械通气对气管插管阻力及其可逆性的影响

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摘要

The study objective was to evaluate endotracheal tubes (ETT) from extubated adult patients and compare them to new, unused, size-matched control tubes for changes in inspiratory resistance (Rinsp) and peak inspiratory pressure (PIP) before and immediately after suctioning with the Airway Medix Closed Suction System (AMCSS) (Biovo Technologies, 2013 Tel Aviv, Israel). Sixteen ETTs were recovered from predominantly medical patients who had required intubation and mechanical ventilation for more than 12 hours. ETTs were evaluated within 4.5 hours of extubation. Readings were taken during square wave flow, at rates of 40 and 60 l/minute. Cleaning of extubated ETTs using the AMCSS was able to restore them to almost original conditions in terms of Ri nsp and PIP. The examined ETTs included tubes of various sizes ranging from internal diameter (ID) 7 to 8.5 mm and intubation periods ranging from 12 hours to 21 days. The mean Rinsp for the used and uncleaned ETTs was equivalent to 275% of the Rinsp of sized-matched new and unused ETTs. For 8 mm ID ETTs this was comparable to a measured Rinsp of a 5 mm tube. Following a single cleaning episode with the AMCSS, Ri nsp decreased, regaining an effective ETT ID of a 7.5 to 8 mm tube. A single suctioning episode with this device resulted in a significant reduction in Rinsp, virtually restoring original flow variable values. The AMCSS represents a novel technology in closed suction systems, designed to achieve more effective inner lumen cleaning in prolonged mechanical ventilation.
机译：该研究的目的是评估拔管成年患者的气管插管（ETT），并将其与新的，未使用的，尺寸匹配的对照管进行比较，以观察吸管前后的吸气阻力（Rinsp）和峰值吸气压力（PIP）的变化。气道Medix封闭式吸气系统（AMCSS）（Biovo Technologies，2013年，以色列特拉维夫）。从需要插管和机械通气超过12小时的主要医学患者中恢复出16例ETT。拔管后4.5小时内评估ETT。在方波流动期间以40和60 l / min的速率读取读数。使用AMCSS清洁拔出的ETT，就可以将Risp和PIP恢复到几乎原始状态。所检查的ETT包括各种尺寸的管，其内径（ID）为7至8.5 mm，插管时间为12小时至21天。使用过的和未清洗的ETT的平均Rinsp相当于尺寸匹配的新ETT和未使用的ETT的Rinsp的275％。对于8 mm ID ETT，这与5 mm管的实测Rinsp相当。在使用AMCSS进行一次清洁后，Rinsp下降，重新获得7.5至8 mm软管的有效ETT ID。使用该设备进行一次抽吸可以显着减少Rinsp，从而实际上恢复了原始流量变量值。 AMCSS代表了封闭式吸气系统中的一项新颖技术，旨在在长时间的机械通气中实现更有效的内腔清洁。

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