Farklı Anestezi Deneyim Düzeyleri Arasında Endotrakeal Tüp Kaf Basıncının Objektif ve Subjektif Değerlendirilmesi

Amaç: Endotrakeal entübasyon (ETI) sonrası endotrakeal tüp kaf (ETTc), işlevini yerine getirebilmesi için yeterli basınçta şişirilmeli, komplikasyonları önlemek için ise yüksek basınçtan kaçınılmalıdır. Çalışmamızda mesleki deneyimin manuel palpasyonla endotrakeal tüp kaf basıncı (ETTcP) tahminine etkisi araştırılmaktadır. Yöntem: Çalışmaya ETI planlanan, Amerikan Anesteziyoloji Derneği (ASA) fiziksel durumu I-III olan, 75 erişkin hasta dahil edildi. Anestezi asistanları 1 ay-1 yıl arasında deneyimi olanlar (Grup1) ve 4 yıldan fazla deneyimi olanlar (Grup 2) şeklinde 20'şer kişilik iki gruba ayrıldı. ETI sonrası, her iki gruptan da bir katılımcıdan ETTc'yi manuel kaf palpasyonu yöntemiyle tahminen 25 cm H2O' ya kadar şişirmesi istendi. Sonra ETTcP’nin gerçek değeri manometre ile ölçüldü. Bulgular: Grup 1’ de median ETTcP değeri 42,00 cm H20, Grup 2 de 32,00 cm H20 idi (p=0.012). Her iki grubun verileri hedef değerden anlamlı derecede yüksek olmakla birlikte, Grup 1’de elde edilen değerler Grup 2’den daha uzaktı (p<0.001, p<0.001). Sonuç: Mesleki deneyim ETTcP değerinin doğru tahmini üzerinde etkili değildir. Hedef değerin dışında ETTcP’nin istenmeyen etkilerini önlemek için gerçek basıncın ölçülmesi daha uygundur.

Anahtar Kelimeler:

Havayolu yönetimi, anestezi asistanları, endotrakeal entübasyon, genel anestezi, mekanik ventilasyon, tıbbi mesleki deneyim

Objective and Subjective Evaluation of Endotracheal Tube Cuff Pressure between Different Levels of Anesthesia Experiences

Objective: After endotracheal intubation (ETI), the endotracheal tube cuff (ETTc) should be inflated at sufficient pressure to function, and high pressure should be avoided to prevent complications. In our study, the effect of professional experience on the estimation of ETTcP by palpation is investigated. Method: The study included 75 adult patients with physical status I-III of the American Society of Anesthesiology (ASA) scheduled for ETI. Anesthesia residents were divided into two groups of 20, each with 1 month to 1 year of experience (Group 1) and those with more than 4 years of experience (Group 2). After the ETI, one participant in both groups was asked to inflate the ETTc to an estimated 25 cm H2O by cuff palpation. Then the actual ETTcP was measured with a manometer. Results: The median ETTcP value was 42,00 cm H2O in Group 1 and 32,00 cm H2O in Group 2, (p=0.012). Although the data of both groups were significantly higher than the target value, the values obtained in Group 1 were further away from Group 2 (p<0.001, p<0.001). Conclusion: Professional experience has no effect on the correct estimation of the ETTcP. It is more convenient to measure the actual pressure to avoid undesirable effects of ETTcP outside the target.

Keywords:

Airway management, anesthesia assistants, endotracheal intubation, general anesthesia, mechanical ventilation, medical professionalism,

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