急速な気管支カフ圧の減少は気管支カフの逸脱を示唆する

DOI 参考文献14件
  • 蒋 奕江
    桂林医科大学麻酔科学講座 (中国) 浜松医科大学麻酔・蘇生学, 集中治療講座
  • 白石 義人
    浜松医科大学附属病院手術部
  • 青木 善孝
    浜松医科大学麻酔・蘇生学, 集中治療講座
  • 佐藤 重仁
    浜松医科大学麻酔・蘇生学, 集中治療講座

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  • Rapid Decrease of Bronchial Cuff Pressure Indicates Slippage of the Bronchial Cuff

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  Purpose: This study aimed to investigate whether or not bronchial cuff pressure decreases when the cuff slips from the bronchial lumen while shifting from the supine to the lateral position.<br>Methods: After the induction of general anesthesia, 18 patients underwent tracheal intubation using a double-lumen tube (DLT) . Following confirmation of the position of the DLT by fiberoptic bronchoscopy, the minimum volume of air was injected into both tracheal and bronchial cuffs to avoid gas leakage. The pressure of both cuffs was recorded before and after shifting from the supine to the lateral position. Using a fiberoptic bronchoscope, we confirmed the position of the bronchial cuff, and investigated the relationship between the change of cuff pressure and slippage of the cuff.<br>Results: The bronchial cuff pressure decreased from 21.2±2.4cmH2O in the supine position to 15.2±7.8cmH2O in the lateral position (mean±SD, P=0.003) . We confirmed a rapid decrease of more than 10cmH2O in the cuff pressures in 6 cases, and all of these bronchial cuffs were found to be partly slipping out of the lumen.<br>Conclusion: The bronchial cuff pressure of the DLT decreased when changing from the supine to the lateral position. The rapid decrease of bronchial cuff pressure (>10cmH2O) seems to be due to slippage of the bronchial cuff from the bronchial lumen. Continuous monitoring of bronchial cuff pressure is necessary to detect slippage of the bronchial cuff.

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