Innovative Tracheal Tube Design Enhances Oral Health in Intubated Patients

IF 2.6 3区 医学 Q2 DERMATOLOGY
Linyan Wang, Han Sheng, Dan-Ying Zhang, Ye-Ping Fei, Zhihong Zhu, Ping Wang
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Abstract

Endotracheal intubation is a crucial intervention for mechanically ventilated patients in the intensive care unit (ICU). However, the presence of the tube and bite block in the mouth significantly raises the risk of mucosal pressure injuries (MMPI) and other oral complications. These complications not only compromise oral health but also prolong hospitalisation and increase medical costs. Despite advances in airway management, effective solutions to mitigate these risks remain limited. Few studies have explored reducing mucosal pressure and improving oral health by optimising the design and reducing the volume of oral devices. Therefore, this study aimed to design and evaluate a novel nested tracheal tube device to reduce oral MMPI and improve oral health outcomes in intubated patients. A prospective, non-blinded, randomised, parallel-controlled intervention study was conducted, involving 151 patients who were intubated for more than 48 h. Participants were randomly assigned into two groups: the intervention group (n = 75), which received the novel nested tracheal tube device, and the control group (n = 76), which received the standard endotracheal tube with bite block. The primary outcome measure was the incidence of MMPI. Secondary outcomes included the Beck Oral Health Score, plaque index, ventilator-associated pneumonia (VAP) and costs. Compared to the standard group, the nested tracheal tube group showed a significant reduction in MMPI (χ2 = 8.796, p < 0.05). In addition, the nested tracheal tube group demonstrated significantly better outcomes in Beck Oral Health Scores (Z = −2.948, p < 0.05) and plaque index (Z = −2.010, p < 0.05), indicating improvements in oral function and hygiene. However, there were no significant differences between the two groups in VAP incidence and average daily ICU costs (p > 0.05). The nested tracheal tube effectively reduces localised pressure on oral tissues and improves oral function, offering a practical solution to mitigate MMPI in mechanically ventilated patients and enhance their oral health outcomes.

Abstract Image

创新气管管设计提高插管患者口腔健康
气管插管是重症监护病房(ICU)机械通气患者的重要干预措施。然而,口腔内的管和咬块的存在显著增加了粘膜压力损伤(MMPI)和其他口腔并发症的风险。这些并发症不仅损害口腔健康,而且延长住院时间,增加医疗费用。尽管在气道管理方面取得了进展,但减轻这些风险的有效解决方案仍然有限。很少有研究探讨通过优化设计和减小口腔装置体积来降低粘膜压力和改善口腔健康。因此,本研究旨在设计和评估一种新型嵌套气管管装置,以减少插管患者的口腔MMPI并改善口腔健康预后。进行了一项前瞻性、非盲、随机、平行对照干预研究,涉及151例插管超过48小时的患者。参与者被随机分为两组:干预组(n = 75)接受新型嵌套气管管装置,对照组(n = 76)接受带咬块的标准气管内管。主要结局指标是MMPI的发生率。次要结局包括贝克口腔健康评分、斑块指数、呼吸机相关性肺炎(VAP)和费用。与标准组比较,嵌套气管管组MMPI明显降低(χ2 = 8.796, p < 0.05)。此外,嵌套气管管组在Beck口腔健康评分(Z = - 2.948, p < 0.05)和牙菌斑指数(Z = - 2.010, p < 0.05)方面均有显著改善,说明口腔功能和卫生得到改善。两组患者VAP发生率及日均ICU费用差异无统计学意义(p > 0.05)。嵌套气管管可有效减轻口腔组织局部压力,改善口腔功能,为减轻机械通气患者的MMPI,提高其口腔健康状况提供了一种实用的解决方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Wound Journal
International Wound Journal DERMATOLOGY-SURGERY
CiteScore
4.50
自引率
12.90%
发文量
266
审稿时长
6-12 weeks
期刊介绍: The Editors welcome papers on all aspects of prevention and treatment of wounds and associated conditions in the fields of surgery, dermatology, oncology, nursing, radiotherapy, physical therapy, occupational therapy and podiatry. The Journal accepts papers in the following categories: - Research papers - Review articles - Clinical studies - Letters - News and Views: international perspectives, education initiatives, guidelines and different activities of groups and societies. Calendar of events The Editors are supported by a board of international experts and a panel of reviewers across a range of disciplines and specialties which ensures only the most current and relevant research is published.
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