Effect Of Different Artificial Airway Cuff Pressure Monitoring Interval Time With Ventilator Associated Pneumonia(VAP)

Objective:In critical patients,compare the difference of the pressure between the different artificial airway cuff pressure monitoring interval time to reach the target pressure;To investigate the relevance of different artificial airway cuff pressure monitoring interval time with ventilator associated pneumonia(VAP);Multivariate analysis was used to find out the possible reasons for the differences,and to provide the direction for further research.Methods:In this study,a randomized controlled trial was conducted,from January 2016 to S-eptember 2016,at Jiangsu province hospital of traditional Chinese medicine,enrolling 56 patients,whose are with tracheal intubation and mechanical ventilation for more than 48 hours,and the patients were randomly divided into 2 groups,one group was is the routine measurement of cuff pressure group,and the other is the increasing measure ment of cuff pressure group,there are 28 cases in each group.The routine measurement of cuff pressure group determined the cuff pressure eve-ry 6 hours,measured the current pressure value,then corrected the original value to 30cmH2O.The increasing measurement of cuff pressure group determined the cuff pressure every 4 hours,measured the current pressure value,then corrected the original value to 30cmH2O.The cuff pressure of the two groups were monitored until the patient successfully pulled out the tracheal intubation or died.The qualified rate of cuff pressure of two groups were calculated(total qualification(the cuff pressure which is more than 20 cmH2O is eligible)/total measuring of cuff pressure×100%).The incidence of VAP between the two groups was calculated.Which were accorded to the diagnostic criteria of VAP in Chinese Medical Association?Guidelines for diagnosis,prevention and treatment of ventilator associated pneumonia(2013)?.The duration of mechanical ventilation,the time of anti infective drugs,the length of stay in ICU,the mortality rate of two groups were statistically analyzed.Result:Qualified rate of cuff pressure:The routine measurement of cuff pressure group measured cuff pressure for 858 times,834 times were qualified(normal value 20?30cmH2O),and qualified rate was 97.25%;The other group measured cuff pressure for 1250 times,1221 times were qualified,and qualified rate was 97.72%.The qualified rate of cuff pressure has no significance between two groups(P>0.05).The incidence of VAP:The incidence of VAP in the routine measurement of cuff pressure group was 14.29%,and the increasing measurement of cuff pressure group was 22.73%,the incidence of VAP has no significance between two groups(P>0.05).Occurrence time of VAP:Occurrence time of VAP has no significance between two groups(P>0.05).The duration of mechanical ventilation:The duration of mechanical ventilation has no significance between two groups(P>0.05).The time of anti infective drugs:The time of anti infective drugs has no significance between two groups(P>0.05).The length of stay in ICU:The length of stay in ICU has no significance between two groups(P>0.05).The mortality rate:The mortality rate has no significance between two groups(P>0.05).Conclusion:In critical patients,when the cuff pressure up to 30cmH2O,monitoring the cuff pressure between every 6hours and every 4hours,the difference between two groups was no significance.The way of monitoring the cuff pressure every 6hours can reduce the workload of nurses,which was worthy of clinical promotion in our country.