Nursing Study Of Cuff-Leak Test To Reduce The Re-Intubation Rate Of Mechanical Ventilation Patients With Intubation

ObjectiveThe patients of intubation to mechanical ventilation,who would often occur edema in airway wall.Wheezing and difficulty breathing occurs in patients after extubation,so we need to re-intubation.This study aimed to explore that predict airway edema appears on different levels after extubation by a cuff leak test,to guide clinician or nurse to choose the right time to extubation,further reducing the chances of patients re-intubation.MethodsThis study selected 200 orotracheal intubation patients with mechanical ventilation and passed the spontaneous breathing test(SBT)before extubation from 1122 patients in ICU of the comprehensive Hospital which loaded in Liaoning province from Oct.2013 to Mar.2016.All of the 200 patients passed the cuff leak test.I got negative and positive groups according to the results.The following criteria was that negative group cuiff leak amount ≥110ml and positive group cuiff leak amount <110ml.All patients would be extubated in the finished cuff leak test,then observation may cause the patients to re-intubation-related indications,such as difficulty breathing,wheezing,airway wall edema severity,thus compare with the two groups in the rate of re-intubation because of the airway wall edema within 24 hours,finally,data analysis and processing applications SPSS17.0 statistical software.ResultsIn the 200 patients,168 patients were the negative of the cuff-leak test as well as 32 patients were the positive of the cuff-leak test.We randomly extract 33 patients as negative group according to 20% proportion from 168 negative patients of the cuff-leak test,32 positive patients of the cuff-leak test as positive group.Comparison between the two groups in sex,age,intubation time,catheter diameter,acute physiology and chronic health evaluation Ⅱscore("APACHEⅡ"),which did not have a significant difference.Two of the 33 patients needed re-intubation in 24 hours after extubation;the re-intubation rate was 6.06%.seven of the 33 patients needed re-intubation in 24 hours after extubation,The re-intubation rate of positive group(21.88%)was clearly higher than negative group,which had significant difference between the two groups.(χ2 =16.87,P<0.05)ConclusionIn the cuff-leak test,the re-intubation rate of negative group is obviously lower than the positive group,which indicates a cuff-leak test can effectively assess the edema degree of airway wall and cut down the re-intubation rate of the patients with invasive mechanism ventilation after extubation.The cuff-leak test is a simple 、non-invasive tool to assess the degree of airway wall edema.The clinician staff can select appropriate time for extubation from patients in orotracheal intubation with mechanical ventilation in accordance with the result of cuff-leak test,which has an important guiding significance.