| Object:With the increase of endotracheal intubation,there are more and more reports about complications of intubation.Postoperative respiratory complications related to endotracheal intubation usually present as cough,sore throat,hoarseness,and blood-streaked expectorant.One important reason is the endotracheal tube cuff（ETTc）pressure.Therefore,this study sought to survey the current situation of ETTc pressure and postoperative intubation-related complications in patients with general anesthesia,and to analyze the influencing factors for improper cuff pressure,moreover,to explore the effect of continuing education on ETTc pressure and complications in patients.Methods:The research was divided into two stages.（1）The first stage was current situation investigation.430 patients who met inclusion criteria in three hospitals in Xinjiang area,scheduled for surgery under general anesthesia with endotracheal intubation from February 2017 to May 2017 were selected as research object by key investigation and convenient sampling method.An investigator measured ETTc pressure using a traditional pressure transducer after intubation.Patients were followed-up after extubation in 24h to observe postoperative intubation-related complications.In accordance with the measured cuff pressure,82patients were regarded as normal cuff pressure group and 348 patients were designated as abnormal cuff pressure group.Comparison of clinical data between the two groups and multivariable logistic regression analysis was performed to predict the risk factors of excessive and insufficient cuff pressure.（2）The second stage:After a series of continuing education on ETTc pressure for anesthesiologists in one of the three hospitals,chose another 255 patients into the research and repeating the steps of the first stage.Results:（1）The first stage:A total of 430 patients included in the study.The measured pressure was（53.3±20.5）cm H2O and only 82 patients had cuff pressure in the recommended range of 2030 cm H2O with the probability was 19.1%.Cases and incidences of sore throat,hoarseness,cough,and blood-streaked expectorant after operative was 305（70.9%）,159（37.0%）,147（34.2%）,and 145（33.7%）.Multivariate logistic regression analysis demonstrated that BMI（≥27,OR=11.000,95%CI 1.064113.731）,smoking history,asthma,or bronchitis history（OR=2.809,95%CI 1.3006.070）in patients and the title of anesthesiologists（Resident,OR=60.224,95%CI 18.853192.380）who inflated the cuff and their working years（≤5 years,OR=68.500,95%CI 15.253307.619）were the independent risk factors of improper cuff pressure.（2）The second stage:After continuing education,the ETTc pressure and the incidence of postoperative intubation-related complications were significantly lower than that in the first stage（P<0.01）.Value of ETTc pressure reduced when professional title and working age of anesthesiologists increased before continuing education in first stage（P<0.05）,but the link between them disappeared after continuing education（P>0.05）.Conclusions:（1）ETTc pressure is much higher than that of recommended in clinical practice and the incidence of intubation-related complications is quite high.（2）Preoperative obesity,smoking history,asthma,or bronchitis history of patients,lower professional title（Resident,Attending）and shorter working years（≤5 years,610 years）of anesthesiologists were risk factors of abnormal endotracheal tube cuff pressure.（3）Continuing education can significantly reduce ETTc pressure and postoperative intubation-related complications in patients;moreover,it is helpful for eliminating the influence of anesthesiologists with different professional title and working age on ETTc pressure. |
