20.500.12556/DKUM-14181 SIMULACIJA TESNJENJA SAPNIČNIH TUBUSOV PRI PREPREČEVANJU VENTILACIJSKE PLJUČNICE (VAP) Simulation of tracheal tube cuff sealing to prevent Ventilator Associated Pneumonia (VAP) V diplomskem delu smo s simulacijskimi pristopi preverjali tesnjenje mešičkov sapničnih tubusov. Tesnjenje je pomembno z vidika preprečevanja ventilacijske pljučnice (VAP) pri intubiranih bolnikih. Raziskavo smo izvedli na vzorcu tubusov štirih proizvajalcev. V simuliranem steklenem sapniku premera 20 mm smo spreminjali tlake mešičkov od 60 cmH2O do 5 cmH2O in opazovali tesnjenje in mikrocirkulacijo. Raziskali smo povezavo med obliko spojke sapničnega tubusa in obliko mešička. Določili smo maksimalen tlak pri katerem pride do rupture mešičkov. Rezultati kažejo, da pri priporočeni vrednosti tlaka za preprečevanje VAP (30 cmH2O) tesni najbolj mešiček tubusa Kimberly-Clark, saj je tesnil v 45 primerih od skupaj izvedenih 45 meritev. Mešiček tubusa Portex je puščal v 6 primerih (13%), mešiček tubusa Mallinckrodt je puščal v 12 primerih (26%) in mešiček tubusa Sheridan je puščal v 6 primerih (13%). Rupturo mešička Kimberly-Clark smo dosegli pri tlaku 832±81 cmH2O, nižje vrednosti pa so bile pri ostalih tubusih (Sheridan 428±42 cmH2O, Mallinckrodt 346±22 cmH2O in Portex 310±22cmH2O). Mešiček Kimberly-Clark tubusa se je izkazal statistično najbolj vzdržljiv izmed vseh izmed vseh štirih testiranih tubusov (P<0,001). Zaključimo, da je najboljše karakteristike v naši raziskavi pokazal nizkotlačni mešiček visokega volumna (low-pressure, high-volume) proizvajalca Kimberly-Clark, zato ga priporočamo pri uporabi v enotah nujne medicinske pomoči na terenu. In this diploma thesis we use simulation to conduct experiments in which we examine effects of cuff sealing in different tracheal tubes. The cuff sealing is important in order to prevent ventilator-associated pneumonia (VAP) in intubated patients. Our research was conducted on a samples of tubes of four manufacturers. In a simulated glass trachea, with 20 mm diameter, we increase the pressure, from 60 cmH2O to 5 cmH2O and watch the seals and microcirculation. We investigated the relationship between tracheal tube connectors and tracheal tube cuffs. We also determined cuff rupture pressure. The results show that the recommended pressure levels for the prevention of VAP (30 cmH2O) prevent leaking only in Kimberly-Clark tracheal tube (45 cases out of a total of 45). Portex tube is leaking in 6 cases (13%), the Mallinckrodt tube in 12 cases (26%) and Sheridan tracheal tube is leaking in 6 cases (13%). Rupture of Kimberly-Clark cuff has been achieved at a pressure of 832 ± 81 cmH2O, lower values were in the other tubes (Sheridan 428 ± 42 cmH2O, Mallinckrodt 346 ± 22 cmH2O and Portex 310 ± 22 cmH2O). Kimberly-Clark tube has proved to be statistically the most endurance of all four tested tubes (P<0,001). We conclude that the best characteristics in our study showed a high-volume, low-pressure cuff of Kimberly-Clark manufacturer and we recommended it for use in emergency medical units on the prehospital settings. tubus tesnilni mešički sapničnih tubusev ventilacijska pljučnica tracheal tube tracheal tube cuff emergency medicine ventilator-associated pneumonia true true false [S. Horvat] Slovenski jezik Angleški jezik Diplomsko delo 2010-05-31 12:26:00 2010-07-02 15:04:54 2022-04-12 11:48:27 2023-12-17 03:10:29 2010 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.24:004.383.4 1609124 URN:SI:UM:DK:OTOGTZUL VS_Horvat_Sanja_2010.pdf VS_Horvat_Sanja_2010.pdf 1 39D466D8ACABBAA9A0F76FAF71ECCD65 2fb2976ca9720f8b18f32a48d918f716b35da6fb3ac90f74e62cab00d40190fb 177f9333-7c04-11eb-bb7a-00155d0001ca 20.500.12556/dkum/dce2759e-af96-47c6-a7cb-c60cf90f6e05 https://dk.um.si/Dokument.php?lang=slv&id=14945 Fakulteta za zdravstvene vede 0 0 0