Revista Brasileira de Terapia Intensiva (Sep 2008)
Análise das pressões de balonetes em diferentes angulações da cabeceira do leito dos pacientes internados em unidade de terapia intensiva Cuff pressure analysis of intensive care unit patients with different inclinations of the head section of the bed
Abstract
OBJETIVOS: A correta insuflação do balonete permite ventilação adequada, além de ser uma das formas de prevenção de pneumonia aspirativa bem como de diversas complicações traqueais. O objetivo deste estudo foi avaliar as pressões de balonetes dos tubos traqueais e/ou cânulas de traqueostomia nas angulações de zero, 30 e 60 graus de inclinação da cabeceira do leito de pacientes internados em unidades de terapia intensiva adulta. MÉTODOS: Realizado estudo transversal, com análise da pressão de balonetes, do volume- corrente expirado (VC) e da pressão de pico das vias aéreas (PP) nas posições de zero, 30 e 60 graus. A angulação de 30 graus foi considerada posição de referência como controle para a análise do comportamento dos valores nas posições de zero a 60 graus, as quais foram escolhidas de forma aleatória. Utilizou-se o teste t de Student, sendo considerado significativo quando p OBJECTIVES: Correct cuff inflation allows appropriate ventilation, and prevents aspiration pneumonia as well as several tracheal complications. The objective of this study was to evaluate endotracheal cuff pressure and/or tracheotomy tubes at zero, 30 and 60 degrees inclination of the patient's bed head section in adult intensive care units. METHODS: A cross sectional study was carried out evaluating the cuff pressure, the expiratory tidal volume (VT) and the peak airway pressure (PP) at inclinations zero, 30 and 60 degree of the head section of the patients' bed. The 30 degree inclination was considered the standard position used as control to analyze values in the zero and 60 degree positions, which were randomly ordered. The Student's t test was used and was considered significant when p < 0.05. RESULTS: A sample of 12 women and 12 men with a mean age of 51.29 ± 19.55 years was surveyed. When inclination of the bed head section was changed from 30 to zero degrees, there was a 16.9% mean reduction of the cuff pressure and 11.8% mean increase of the PP. On the other hand, changing the position from 30 to 60 degrees caused a mean reduction of 18.8% in the cuff pressure and a mean increase of 13.3% in the PP. Findings were significant when p < 0.05. CONCLUSIONS: To prevent air leak and risk of aspiration pneumonia, adequate adjustments and monitoring of the patients cuff pressure are necessary when inclination of the bed head section is changed.
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