Clinical Use of the Volume-Time Curve for Endotracheal Tube Cuff Management
| Autor: | Sonia Maria Faresin, Antonio Carlos Carvalho, Douglas W. Bolzan, Walter J. Gomes, de Paola Aa, Solange Guizilini, Thatiana C.A. Peixoto |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Spirometry medicine.medical_specialty medicine.medical_treatment Critical Care and Intensive Care Medicine Pulmonary function testing FEV1/FVC ratio Double-Blind Method Intubation Intratracheal Pressure medicine Sore throat Humans Intubation Postoperative Care medicine.diagnostic_test business.industry Pharyngitis Equipment Design General Medicine Middle Aged Surgery Intensity (physics) medicine.anatomical_structure Cough Anesthesia Cuff Airway Extubation Female medicine.symptom business Artery |
| Zdroj: | Respiratory Care. 59:1628-1635 |
| ISSN: | 1943-3654 0020-1324 |
| Popis: | BACKGROUND: Previous investigation showed that the volume-time curve technique could be an alternative for endotracheal tube (ETT) cuff management. However, the clinical impact of the volume-time curve application has not been documented. The purpose of this study was to compare the occurrence and intensity of a sore throat, cough, thoracic pain, and pulmonary function between these 2 techniques for ETT cuff management: volume-time curve technique versus minimal occlusive volume (MOV) technique after coronary artery bypass grafting. METHODS: A total of 450 subjects were randomized into 2 groups for cuff management after intubation: MOV group ( n = 222) and volume-time curve group ( n = 228). We measured cuff pressure before extubation. We performed spirometry 24 h before and after surgery. We graded sore throat and cough according to a 4-point scale at 1, 24, 72, and 120 h after extubation and assessed thoracic pain at 24 h after extubation and quantified the level of pain by a 10-point scale. RESULTS: The volume-time curve group presented significantly lower cuff pressure (30.9 ± 2.8 vs 37.7 ± 3.4 cm H2O), less incidence and intensity of sore throat (1 h, 23.7 vs 51.4%; and 24 h, 18.9 vs 40.5%, P < .001), cough (1 h, 19.3 vs 48.6%; and 24 h, 18.4 vs 42.3%, P < .001), thoracic pain (5.2 ± 1.8 vs 7.1 ± 1.7), better preservation of FVC (49.5 ± 9.9 vs 41.8 ± 12.9%, P = .005), and FEV1 (46.6 ± 1.8 vs 38.6 ± 1.4%, P = .005) compared with the MOV group. CONCLUSIONS: The subjects who received the volume-time curve technique for ETT cuff management presented a significantly lower incidence and severity of sore throat and cough, less thoracic pain, and minimally impaired pulmonary function than those subjects who received the MOV technique during the first 24 h after coronary artery bypass grafting. |
| Databáze: | OpenAIRE |
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