İlkay BARAN, Savaş ALTINSOY, Özge YAMANKILIÇ MUMCU, Aslı DÖNMEZ

Endotrakeal Kaf İnflasyon Yöntemlerine Bağlı Yüksek İntraoperatif Kaf Basıncı İnsidansı ve Klinik Etkileri

Amaç: Endotrakeal tüpe ait kafın en önemli fonksiyonu pozitif basınçlı ventilasyon sırasında kaçak oluş- turmaması ve faringeal içeriğin aspirasyonunu engellemesidir. Endotrakeal tüp kaflarının şişirilmesi için farklı uygulamalar kullanılmaktadır. Çalışmamızın amacı uygulanan yöntemlerin güvenli ölçüm değerle- rini sağlayıp sağlamadığını kontrol etmek ve bu konudaki farkındalığın gözden geçirilmesidir. Yöntem: Etik Kurul onayı alındıktan sonra ASA I-IV risk grubunda 249 hasta dahil edildi. Rutin anestezi monitörizasyonu uygulanan hastalara rutin indüksiyon ve idamesi uygulandı. Tüm hastaların demogra- fik verileri, tüp no, kaf pilot şişirme yöntemi ve şişiren kişiler kaydedildi. Sonrasında 15. dk.’da kaf basın- cı manometre ile ölçüldü ve kaydedildi. Yüksek bulunan basınçlar normal aralığa kaçak olmayacak şekilde indirildi. Derlenme odasında ve 24. saatte boğaz ağrısı, ses kısıklığı ve yutma güçlüğü açısından komplikasyonlar kaydedildi. Bulgular: Çalışmamıza 249 hasta dahil edildi. Hiçbir hasta güvenli kabul edilen 20 cmH 2 O’un altında kaf basıncına sahip değildi. Hastalar kaf basınçlarına göre Grup N (20-30 cmH 2 O), Grup I (30-50 cmH 2 O), Grup II (50-70 cmH 2 O) ve Grup III (>70 cmH 2 O) olacak şekilde dört gruba ayrıldı. İki yüz kırk dokuz has- tanın 18’i Grup N (%7.2), 105 hasta (%42.1) Grup I, 50 hasta (%20) Grup II, 76 hasta (%30.5) en yüksek basınç grubu olan Grup III’te idi. Hastaların % 78’inde palpasyon yönteminin kullanıldığı bulundu (p

High Intraoperative Cuff Pressure Incidence Due to Endotracheal Cuff Inflation Methods and Its Clinical Effects

Objective: The most important function of the endotracheal tube cuff is that it does not cause leakage during positive pressure ventilation and prevents aspiration of pharyngeal content. endotracheal tube cuff. Different methods are used for inflating cuffs. The aim of this study is to check whether these methods provide safe measurement values and to review the awareness about this issue. Method: After approval of the local ethics committee was obtained, 249 patients in the ASA I-IV risk group were included. Routine induction and maintenance of anesthesia was applied for patients under- going routine anesthesia monitoring. Demographic data, tube number, cuff pilot inflation method and the individuals who inflated the cuffs were recorded. After 15 minutes, the cuff pressure was measured with the manometer and recorded. High pressures were lowered to the normal range without causing leakage. Complications in the recovery room and at the 24th hour as for sore throat, hoarseness and dysphagia were recorded. Results: A total of 249 patients were included in this study. None of the patients had cuff pressures below the acceptable safe limit of 20 cmH 2 O. Patients were divided into four groups according to cuff pressures: Group N (20-30 cmH 2 O), group I (30-50 cmH 2 O), Group II (50-70 cmH 2 O) and Group III (>70 cmH 2 O). Eighteen (7.2%) patients were in Group N, 105 (42.1%) were in Group I, 50 (20%) were in Group II, 76 patients (30.5%) were in Group III with the highest cuff pressure. Palpation method was used in 78% of the patients (p

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