ENDOTRAKEAL TÜP KAF BASINCI İZLEMİ: KLİNİK PİLOT ÇALIŞMA

Yıl 2018, Cilt: 34 Sayı: 2, 44 - 54, 28.08.2018

Türkan Özbayır , Nurten Taşdemir , Mehmet Uyar Meryem Yavuz Van Giersbergen Gülay Çankaya Gülin Dinçaslan

Öz

Başlık:  ENDOTRAKEAL
TÜP KAF BASINCI İZLEMİ: KLİNİK PİLOT ÇALIŞMA

Özet: Amaç: Endotrakeal entübasyon yoğun bakım
ünitelerinde tedavi gören hastalara sıklıkla uygulanmaktadır. Endotrakeal tüp bakımı
ve izlemi hemşirelik aktiviteleri içinde yer almaktadır. Araştırma, düzenli
endotrakeal kaf basıncı izleminin yoğun bakım ünitesi hemşirelik bakımımı
uygulamalarına dâhil olması amacıyla prospektif klinik pilot çalışma olarak yürütüldü.

Gereç ve Yöntem: Araştırmanın örneklemini yoğun bakım ünitesinde görev yapan 40 hemşire
ve üç aylık izlem süresince bu ünitede tedavi gören 168 hastanın kaf basıncı
izlem değerleri oluşturdu. Yoğun bakım hemşirelerine kaf basıncı ve yönetimi
konusunda çok yönlü eğitim programı verildi. Eğitim öncesi ve eğitimden 3 ay
sonra bilgi düzeyleri kaf izleme formları ile değerlendirildi.

Bulgular: Endotrakeal
tüp kaf basını ölçümüne yönelik verilen eğitimin
hemşirelerin bilgi düzeylerini
arttırdığı ve uygulanan eğitimden tamamına yakının olumlu değerlendirdikleri
saptandı. Eğitim sonrası üç aylık izlem sürecinde kaf basıncı değerlerinin
%66,31 oranında kaydedildiği belirlenmiştir. Endotrakeal tüp kaf basıncı ölçüm
değerlerinin literatürde belirtilen güvenli sınır aralığının üzerinde olduğu
saptandı.

Sonuç: Endotrakeal
tüp kaf basıncı ölçüm değerlerinin literatürde belirtilen güvenli sınır aralığının
üzerinde olduğu saptandı.  

Anahtar kelimeler:   Kaf basıncı, Endotrakeal
tüp, Yoğun bakım hemşireliği, Monitorizasyon.

Destekleyen kurumlar: Bu
araştırma Ege Üniversitesi, Bilimsel Araştırma Projeleri Koordinasyon Birimi
tarafından desteklenmiştir (Proje No: 2010/ HYO/001).

Kaynakça: Bhatta
K., Greer R. Awareness and Monitoring Of Tracheal Tube Cuff Pressure in a
Multidisciplinary İntensive Care Unit. Anaesthesia and Intensive Care 2007; (35)
2; 302- 303. 

Braz JRC, Navarro LHC, Takata
IH, Nascimento Júnior P. Endotracheal
Tube Cuff Pressure: Need for Precise Measurement. Sao Paulo Med J 1999;
117(6):243-247.

Chan
S, Wong C, Cherng C. (2009). Determining an optimal tracheal tube cuff pressure
by the feel of the pilot balloon: a training course for trainees providing
airway care. Acta Anaesthesiol Taiwan; 47(2):79−83.

Duguet A, D’Amico L, Biondi G, Prodanovic H, Gonzalez- Bermejo J,
Similowski T. Control of Tracheal Cuff Pressure: A Pilot Study Using a
Pneumatic Device. Intensive Care Med 2007;
33:128-132.

Efrati S, Deutsch I, Gurman GM, Noff M, Conti G. Tracheal Pressure and
Endotracheal Tube Obstruction Can be Detected by Continuous Cuff Pressure
Monitoring: In Vitro Pilot Study. Intensive Care Med 2010; 36:984–990.

Ganner C,The Accurate
Measurement of Endotracheal Tube Cuff
Pressures. British Journal of Nursing 2001; 10 (17); 1127- 1134.

Godoy, A C F D, Vieira RJ, Capitani, EMD.
Endotracheal Tube Cuff Pressure Alteration After Changes in Position in
Patients Under Mechanical Ventilation. Jornal Brasileiro de Pneumologia 2008; 34(5),
294-297.

Jaber
S, Kamel ME, Chanques G, Mustapha Sebbane M. Et al.  Endotracheal Tube Cuff Pressure in Intensive
Care Unit: The Need for Pressure Monitoring. Intensive Care Medicine 2007; 33: 917–918.

Jordan P, van Rooyen, Venter D.
Endotracheal Tube Cuff Pressure Cuff Pressure Management in Adult Intensive
Care Units. S Afr J Crit Care 2012;28(1):13-16.

Kim D, Jeon B, Son  JS,  Lee
JR, Ko S, Lim H. The Changes of Endotracheal Tube Cuff Pressure by the Position
Changes From Supine to Prone and the Flexion and Extension of Head. Korean
Journal of Anesthesiology, 2015; 68(1), 27-31.

Labeau SO, Bleiman M, Rello J, Vandijck DM, Claes B,
Blot SI. Knowledge and Management of Endotracheal Tube Cuffs. International
Journal Of Nursing Studies 2015; 52(1), 498-499.

Lizy
C, Swinnen W, Labeau S, Blot S. Deviations in Endotracheal Cuff Pressure During
Intensive Care, American Journal of Critical Care 2011; 20(6), 421-26.

Lizy
C, Swinnen W, Labeau S, Poelaert
J, Vogelaers D, Vandewoude K, Dulhunty J, 
Blot S. Cuff Pressure of Endotracheal Tubes After Changes in Body
Position in Critically İll Patients Treated with Mechanical Ventilation. American Journal of Critical Care 2014; 23(1), e1-e8.

Micik S, Besic N, Johnson N, Han M, Hamlyn S, Ball H. Reducing
Risk For Ventilator Associated Pneumonia Through Nursing Sensitive
İnterventions. İntensive and Clinical Care Nursing 2013; 29(59:261-265

Mol DA, De Villiers GDT,
Claassen AJ. Use and Care of an
Endotracheal/Tracheostomy Tube Cuff - Are İntensive Care Unit Staff Adequately
İnformed?. SAJS 2004; 42, 1; 14-16.

Nseir S, Brisson H, Marquettec
CH, Chaudd P, et al. (2009) Variations in Endotracheal Cuff Pressure in
Intubated Critically Ill Patients: Prevalence and Risk Factors. European
Journal of Anaesthesiology, 2009; 26;229–234.

Nseir S. Endotracheal Cuff Pressure
Monitoring: Another Alarm in the ICU? American Journal of Critical Care 2011, 20(6),
421-26.

Rose L, Redl L. Survey of Cuff
Management Practices in Intensive Care Units in Australia and New Zeland.
American Journal of Critical Care 2008; 17 (5); 428- 435.

Rose L, Redl L. (2008 a).
Survey of cuff management practices in intensive care units in Australia and
New Zeland. American Journal of Critical Care; 17 (5): 428-435.

Sengupta P. Sessler DI. Maglinger P. Wells S. Endotracheal Tube Cuff Pressure in Three Hospitals, and the Volume
Required to Produce an Appropriate Cuff Pressure. BMC Anesthesiology 2004, 4: 8.

Sole ML, Aragon D, Bennett M,
Johnson R. Continuous Measurement of Endotracheal Tube Cuff Pressure How
Difficult Can It Be? AACN 2008; 19(2), 235-43

Sole ML, Su X, Talbert S,
Penoyer AD, Kalita SEvaluation of an Intervention to Maintain Endotracheal Tube
Cuff Pressure within Therapeutic Range. American Journal of Critical Care 2011;
20(2): 109-117.

Spittle CNS, Beavis SE, Do you measure tracheal cuff pressure? A survey
of clinical practice. Brit. J. Anaesth. 2001; 87 (2), 344-345.

Tekin Y E, İyigün E. Yoğun bakım Ünitelerinde Hemşirelerin
Trakeostomi/Endotrakeal Tüp Kaf Basıncı Uygulamalarının İncelenmesi, Türkiye
KlinikleriJ Nurs Sci 2016; 8(1)26-33

Vyas
D, Inweregbu
K, Pittard A. Measurement of Tracheal Tube Cuff Pressure in Critical Care.
Anahesthesia. 2002; 57: 275-277.

Zand F, Nekooeian AA, Rohani M. Endotracheal
Tube Cuff Pressure Monitoring in Intensive Care Units. Iranian Red Crescent Medical
Journal 2008; 10(3):223-227.

 

Anahtar Kelimeler

Kaf basıncı, Endotrakeal tüp, Yoğun bakım hemşireliği

Kaynakça

• Bhatta K., Greer R. Awareness and Monitoring Of Tracheal Tube Cuff Pressure in a Multidisciplinary İntensive Care Unit. Anaesthesia and Intensive Care 2007; (35) 2; 302- 303.
• Braz JRC, Navarro LHC, Takata IH, Nascimento Júnior P. Endotracheal Tube Cuff Pressure: Need for Precise Measurement. Sao Paulo Med J 1999; 117(6):243-247.Chan S, Wong C, Cherng C. (2009). Determining an optimal tracheal tube cuff pressure by the feel of the pilot balloon: a training course for trainees providing airway care. Acta Anaesthesiol Taiwan; 47(2):79−83.
• Duguet A, D’Amico L, Biondi G, Prodanovic H, Gonzalez- Bermejo J, Similowski T. Control of Tracheal Cuff Pressure: A Pilot Study Using a Pneumatic Device. Intensive Care Med 2007; 33:128-132.
• Efrati S, Deutsch I, Gurman GM, Noff M, Conti G. Tracheal Pressure and Endotracheal Tube Obstruction Can be Detected by Continuous Cuff Pressure Monitoring: In Vitro Pilot Study. Intensive Care Med 2010; 36:984–990.
• Ganner C,The Accurate Measurement of Endotracheal Tube Cuff Pressures. British Journal of Nursing 2001; 10 (17); 1127- 1134. Godoy, A C F D, Vieira RJ, Capitani, EMD. Endotracheal Tube Cuff Pressure Alteration After Changes in Position in Patients Under Mechanical Ventilation. Jornal Brasileiro de Pneumologia 2008; 34(5), 294-297.
• Jaber S, Kamel ME, Chanques G, Mustapha Sebbane M. Et al. Endotracheal Tube Cuff Pressure in Intensive Care Unit: The Need for Pressure Monitoring. Intensive Care Medicine 2007; 33: 917–918.
• Jordan P, van Rooyen, Venter D. Endotracheal Tube Cuff Pressure Cuff Pressure Management in Adult Intensive Care Units. S Afr J Crit Care 2012;28(1):13-16.Kim D, Jeon B, Son JS, Lee JR, Ko S, Lim H. The Changes of Endotracheal Tube Cuff Pressure by the Position Changes From Supine to Prone and the Flexion and Extension of Head. Korean Journal of Anesthesiology, 2015; 68(1), 27-31.
• Labeau SO, Bleiman M, Rello J, Vandijck DM, Claes B, Blot SI. Knowledge and Management of Endotracheal Tube Cuffs. International Journal Of Nursing Studies 2015; 52(1), 498-499.
• Lizy C, Swinnen W, Labeau S, Blot S. Deviations in Endotracheal Cuff Pressure During Intensive Care, American Journal of Critical Care 2011; 20(6), 421-26.
• Lizy C, Swinnen W, Labeau S, Poelaert J, Vogelaers D, Vandewoude K, Dulhunty J, Blot S. Cuff Pressure of Endotracheal Tubes After Changes in Body Position in Critically İll Patients Treated with Mechanical Ventilation. American Journal of Critical Care 2014; 23(1), e1-e8.
• Micik S, Besic N, Johnson N, Han M, Hamlyn S, Ball H. Reducing Risk For Ventilator Associated Pneumonia Through Nursing Sensitive İnterventions. İntensive and Clinical Care Nursing 2013; 29(59:261-265
• Mol DA, De Villiers GDT, Claassen AJ. Use and Care of an Endotracheal/Tracheostomy Tube Cuff - Are İntensive Care Unit Staff Adequately İnformed?. SAJS 2004; 42, 1; 14-16.
• Nseir S, Brisson H, Marquettec CH, Chaudd P, et al. (2009) Variations in Endotracheal Cuff Pressure in Intubated Critically Ill Patients: Prevalence and Risk Factors. European Journal of Anaesthesiology, 2009; 26;229–234.
• Nseir S. Endotracheal Cuff Pressure Monitoring: Another Alarm in the ICU? American Journal of Critical Care 2011, 20(6), 421-26.
• Rose L, Redl L. Survey of Cuff Management Practices in Intensive Care Units in Australia and New Zeland. American Journal of Critical Care 2008; 17 (5); 428- 435.
• Rose L, Redl L. (2008 a). Survey of cuff management practices in intensive care units in Australia and New Zeland. American Journal of Critical Care; 17 (5): 428-435.
• Sengupta P. Sessler DI. Maglinger P. Wells S. Endotracheal Tube Cuff Pressure in Three Hospitals, and the Volume Required to Produce an Appropriate Cuff Pressure. BMC Anesthesiology 2004, 4: 8.
• Sole ML, Aragon D, Bennett M, Johnson R. Continuous Measurement of Endotracheal Tube Cuff Pressure How Difficult Can It Be? AACN 2008; 19(2), 235-43
• Sole ML, Su X, Talbert S, Penoyer AD, Kalita SEvaluation of an Intervention to Maintain Endotracheal Tube Cuff Pressure within Therapeutic Range. American Journal of Critical Care 2011; 20(2): 109-117.
• Spittle CNS, Beavis SE, Do you measure tracheal cuff pressure? A survey of clinical practice. Brit. J. Anaesth. 2001; 87 (2), 344-345.
• Tekin Y E, İyigün E. Yoğun bakım Ünitelerinde Hemşirelerin Trakeostomi/Endotrakeal Tüp Kaf Basıncı Uygulamalarının İncelenmesi, Türkiye KlinikleriJ Nurs Sci 2016; 8(1)26-33
• Vyas D, Inweregbu K, Pittard A. Measurement of Tracheal Tube Cuff Pressure in Critical Care. Anahesthesia. 2002; 57: 275-277.
• Zand F, Nekooeian AA, Rohani M. Endotracheal Tube Cuff Pressure Monitoring in Intensive Care Units. Iranian Red Crescent Medical Journal 2008; 10(3):223-227.