Author/Editor		Kučan, Marko; Djekić, Bernarda; Ravljen, Mirjam
Title		The influence of the endotracheal tube cuff on the occurrence of ventilator-associated pneumonia
Translated title		Vpliv mešička tubusa na pojav ventilatorske pljučnice
Type		članek
Vol. and No.		Letnik 49, št. 3
Publication year		2015
Volume		str. 222-232
ISSN		1318-2951 - Obzornik Zdravstvene Nege
Language		eng
Abstract		Introduction: An endotracheal tube enables patient ventilation, but also presents a risk of complications. The accumulation of subglottic secretions above the cuff may cause ventilatorassociated pneumonia. The purpose of the article is to establish the effect of the endotracheal tube cuff (shape and material, method of inflation, verifying and maintaining pressure) on the incidence of ventilator-associated pneumonia. Methods: A descriptive method with a systematic review of domestic and foreign literature was used. The literature was retrieved from electronic databases and the cooperative bibliographic/catalogue database. According to eligibility criteria, sixteen original scientific articles published in the last ten years were finally used. Data were processed with qualitative content analysis. Results: Cuff inflation control with a manometer and continuous measuring and adjustment of cuff pressure with modern equipment were found to be the safest methods. According to the articles on shape and material, conical polyurethane cuffs provide the best sealing. Discussion and conclusion: Ventilator-associated pneumonia is a serious complication in mechanically ventilated patients. Maintaining appropriate cuff pressure proved to be a very effective preventive measure. The research presented here is limited by the small number of available articles. Further research is needed before practical applications are attempted.Uvod: Endotrahealni tubus omogoča predihavanje pacienta, a hkrati pomeni tveganje za razvoj zapletov. Nad mešičkom tubusa se nabira sekret, ki lahko povzroči ventilatorsko pljučnico. Namen članka je ugotoviti, ali mešiček tubusa (oblika in material ter način napihovanja, preverjanja in vzdrževanja tlaka) vpliva na incidenco ventilatorske pljučnice. Metode: Uporabljena je bila deskriptivna metoda dela s sistematičnim pregledom domače in tuje literature. Članki so bili najdeni s pomočjo elektronskih podatkovnih baz in vzajemne bibliografsko-kataloške baze podatkov. Za iskanje odgovorov na raziskovalna vprašanja smo glede na vključitvene in izključitvene kriterije uporabili 16 izvirnih znanstvenih člankov iz obdobja zadnjih 10 let. Podatki so bili po izboru obdelani s kvalitativno vsebinsko analizo. Rezultati: Ugotovljeno je bilo, da je najbolj varno napihovanje mešička z manometrom ter kontinuirano merjenje in sprotno prilagajanje tlaka v mešičku s pomočjo sodobnih pripomočkov. Najboljšo funkcijo tesnjenja je nudil poliuretanski koničasti mešiček, kar potrjujejo vsi članki o materialu in obliki. Diskusija in zaključek: Ventilatorska pljučnica je resen zaplet mehanske ventilacije. Vzdrževanje primernega tlaka v mešičku je učinkovit preventivni ukrep, vendar je uspeh možen samo ob sočasnem izvajanju ostalih potrebnih ukrepov. Predstavljena raziskava je omejena z majhnim številom člankov, zato bodo pred uvajanjem sprememb v prakso potrebne nove raziskave.
Keywords		ventilatorska pljučnica preprečevanje mešiček tlak oblika material zdravstvena nega ventilator associated pneumonia prevention cuff pressure shape material nursing