fa مقایسه فشار کاف لوله تراشه پر شده توسط پرسنل تیم بیهوشی برحسب سطح تحصیلات تخصصي Special پژوهشي Research <div style="text-align: justify;"><span style="line-height:2;"><span style="color:#000000;"><span style="font-size:14px;"><span style="font-family:IRANsans;"><span style="background:#d9d9d9"><span style="direction:rtl"><span style="unicode-bidi:embed"><b><span lang="FA"><span style="background-color:#ffffff;">زمینه و هدف</span></span></b><span lang="FA"><span style="background-color:#ffffff;">: انتوباسیون تراشه به‌صورت مکرر در اتاق عمل انجام می‌شود. پر شدگی بیش از حد کاف لوله تراشه، یک عامل خطر برای ایسکمی تراشه و عوارض پس از آن است. از سوی دیگر فشار کاف ناکافی خطر آسپیراسیون محتویات معده را افزایش می‌دهد. در این مطالعه فشار کاف لوله تراشه پر شده توسط پرسنل تیم بیهوشی مقایسه شده است.</span><span style="color:#333333"></span></span></span></span></span><br> <span style="direction:rtl"><span style="unicode-bidi:embed"><b><span lang="FA"><span style="background-color:#ffffff;">روش‌‌شناسی:</span></span></b><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">در </span></span><span lang="FA"><span style="background-color:#ffffff;">یک مطالعه</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">مقطعی</span></span><span lang="FA"><span style="background-color:#ffffff;">، </span></span><span lang="FA"><span style="background-color:#ffffff;">ما</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">فشار کاف</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">لوله تراشه</span></span><span lang="FA"><span style="background-color:#ffffff;"> پر شده توسط 80 نفر از </span></span><span lang="FA"><span style="background-color:#ffffff;">متخصصین بیهوشی</span></span><span lang="FA"><span style="background-color:#ffffff;">، پرستاران </span></span><span lang="FA"><span style="background-color:#ffffff;">بیهوشی</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">و دستیاران</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">بیهوشی</span></span><span lang="FA"><span style="background-color:#ffffff;"> را با یک مانومتر مورد ارزیابی قرار دادیم.</span></span><span lang="FA"><span style="background-color:#ffffff;"> لوله‌های با حجم بالا و کم فشار برای لوله‌گذاری در تمام بیماران مورد استفاده قرار گرفت. متخصص بیهوشی و پرسنل دیگر از مطالعه برنامه‌ریزی شده اطلاعی نداشتند. </span></span><span lang="FA" style="font-family:"B Nazanin""></span></span></span><br> <span style="background:#d9d9d9"><span style="direction:rtl"><span style="unicode-bidi:embed"><b><span lang="FA"><span style="background-color:#ffffff;">یافته‌ها:</span></span></b><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">فشار </span></span><span lang="FA"><span style="background-color:#ffffff;">متوسط</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">کاف</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">لوله تراشه</span></span><span lang="FA"><span style="background-color:#ffffff;"> پر شده توسط </span></span><span lang="FA"><span style="background-color:#ffffff;">متخصصین بیهوشی</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">و دستیاران</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">بیهوشی</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">ارشد</span></span><span lang="FA"><span style="background-color:#ffffff;">، پرستاران </span></span><span lang="FA"><span style="background-color:#ffffff;">با</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">1</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">به 14 سال</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">تجربه در</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">بیهوشی</span></span><span lang="FA"><span style="background-color:#ffffff;">، پرستاران </span></span><span lang="FA"><span style="background-color:#ffffff;">ارشد</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">15-30</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">سال</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">تجربه در زمینه</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">بیهوشی</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">و</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">دستیاران</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">بیهوشی</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">سال پایین به‌ترتیب</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">24 </span></span><span lang="FA"><span style="background-color:#ffffff;">&plusmn;</span></span><span lang="FA"><span style="background-color:#ffffff;"> 49.24،</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">29 </span></span><span lang="FA"><span style="background-color:#ffffff;">&plusmn; </span></span><span lang="FA"><span style="background-color:#ffffff;">&nbsp;70.8</span></span><span style="background-color:#ffffff;">&nbsp;</span><span lang="FA"><span style="background-color:#ffffff;">،</span></span><span style="background-color:#ffffff;">&nbsp; </span><span lang="FA"><span style="background-color:#ffffff;">20 </span></span><span lang="FA"><span style="background-color:#ffffff;">&plusmn;</span></span><span lang="FA"><span style="background-color:#ffffff;"> 56.8 و</span></span><span style="background-color:#ffffff;">&nbsp;&nbsp; </span><span lang="FA"><span style="background-color:#ffffff;">29 </span></span><span lang="FA"><span style="background-color:#ffffff;">&plusmn;</span></span><span lang="FA"><span style="background-color:#ffffff;"> 73.5 </span></span><span dir="LTR"><span style="background-color:#ffffff;">mmHg </span></span><span lang="FA"><span style="background-color:#ffffff;">&nbsp;ب</span></span><span lang="FA"><span style="background-color:#ffffff;">ود.</span></span><span lang="FA" style="font-family:"B Nazanin""></span></span></span></span><br> <span style="direction:rtl"><span style="unicode-bidi:embed"><b><span lang="FA"><span style="background-color:#ffffff;">نتیجه‌گیری</span></span></b><span lang="FA"><span style="background-color:#ffffff;">: </span></span><span lang="FA"><span style="background-color:#ffffff;">تمایل به</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">پر کردن بیش از حد کاف</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">لوله تراشه</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">در</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">تمام</span></span><span lang="FA"><span style="background-color:#ffffff;"> افراد </span></span><span lang="FA"><span style="background-color:#ffffff;">تیم</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">بیهوشی</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">دیده شد.</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">لمس پیلوت </span></span><span lang="FA"><span style="background-color:#ffffff;">به‌منظور ارزیابی</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">کفایت</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">پرشدگی</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">کاف</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">کافی نیست</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">و</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">افراد بیهوشی دهنده</span></span><span lang="FA"><span style="background-color:#ffffff;"> بهتر است از مانومتر‌های اندازه‌گیری فشار کاف لوله تراشه </span></span><span lang="FA"><span style="background-color:#ffffff;">برای اندازه</span></span><span lang="FA"><span style="background-color:#ffffff;">‌</span></span><span lang="FA"><span style="background-color:#ffffff;">گیری</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">دقیق</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">فشار</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">کاف</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">لوله</span></span><span style="background-color:#ffffff;"> </span><span lang="FA"><span style="background-color:#ffffff;">داخل تراشه</span></span><span lang="FA"><span style="background-color:#ffffff;"> و پر‌شدن مناسب آن </span></span><span lang="FA"><span style="background-color:#ffffff;">استفاده نمایند</span></span><span lang="FA"><span style="background-color:#ffffff;">.</span></span></span></span></span></span></span></span><span style="font-size:14px;"><span style="font-family:IRANsans;"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span lang="FA"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></div> <div style="text-align: justify;"><span style="color:#000000;"><span style="font-size:11pt"><span style="unicode-bidi:embed"><span style="line-height:115%"><span new="" roman="" times=""><b>Background & Objectives:</b> Tracheal intubation is frequently performed in operating room. Over inflation of the endotracheal tube cuff is a risk factor for tracheal ischemia and subsequent complications. On the other hand inadequate cuff pressure increases the risk of aspiration of gastric contents. In this study, the endotracheal tube cuff pressure filled by the anesthesia team has been compared.</span></span></span></span><br> <span style="font-size:11pt"><span style="unicode-bidi:embed"><span style="line-height:115%"><span new="" roman="" times=""><b>Material & Methods:</b> In this cross-sectional study, we assessed the tracheal tube cuff inflation pressure among 80 anesthesiologists, nurses of anesthesia, and anesthesiology assistants using a manometer. High-volume, low-pressure tubes were used for intubation in all patients. The anesthesiologists and other personnel were not informed of the planned study.</span></span></span></span><br> <span style="font-size:11pt"><span style="unicode-bidi:embed"><span style="line-height:115%"><span new="" roman="" times=""><b>Results:</b> The average pressure generated by inflating the endotracheal tube cuff among anesthesiologists and senior anesthesia assistants, junior nurses with 1 to 15 years of experience in anesthesia, senior nurses with 15-30 years of experience in anesthesia and, junior anesthesia assistants were 49.24&plusmn;24, 70.8&plusmn;29, 56.8&plusmn;20 and 73.5&plusmn;29 mmHg, respectively.</span></span></span></span><br> <span style="font-size:11pt"><span style="unicode-bidi:embed"><span style="line-height:115%"><span new="" roman="" times=""><b>Conclusion: </b>There is a tendency to over inflation of endotracheal tube cuffs in all anesthesia team. Palpation in order to assess the adequacy of cuff inflation is not sufficient and anesthesia providers should consider using devices such as manometers to facilitate safe inflation and accurate measurement of endotracheal tube cuff pressure.</span></span></span></span></span></div> لوله گذاری داخل تراشه, ایسکمی, تیم بیهوشی دهنده, فشار کاف Intubation, Intratracheal, Ischemia, Anesthesia team, Cuff pressure 14 24 http://rsj.iums.ac.ir/browse.php?a_code=A-10-205-2&slc_lang=fa&sid=1 Alireza Mahoori علیرضا ماهوری mahori.a@umsu.ac.ir 10031947532846001856 10031947532846001856 No Urmia University of Medical Sciences دانشگاه علوم پزشکی ارومیه Tohid Karami توحید کرمی karami.t@umsu.ac.ir 10031947532846001857 10031947532846001857 Yes Urmia University of Medical Sciences دانشگاه علوم پزشکی ارومیه Sonia Karami سونیا کرمی karami.s@umsu.ac.ir 10031947532846001858 10031947532846001858 No Urmia University of Medical Sciences دانشگاه علوم پزشکی ارومیه