Fixierung des oralen Endotrachealtubus in der
          Intensivtherapie

Oliver Rothaug; Rolf Dubb; Arnold Kaltwasser; Carsten Hermes; Tilmann Müller-Wolff; Bernhard Stork; Hans-Peter Hebenstreit

doi:10.1055/s-0032-1329427

intensiv, Table of Contents

intensiv 2012; 20(06): 296-302
DOI: 10.1055/s-0032-1329427

Intensivpflege

Tubusfixierung

Georg Thieme Verlag KG Stuttgart · New York

Fixierung des oralen Endotrachealtubus in der Intensivtherapie

Oliver Rothaug

¹Universitätsmedizin Göttingen

,

Rolf Dubb

³Klinikum Stuttgart, Katharinen Hospital

,

Arnold Kaltwasser

²Akademie der Kreiskliniken Reutlingen

,

Carsten Hermes

⁴Helios-Kliniken, Siegburg

,

Tilmann Müller-Wolff

²Akademie der Kreiskliniken Reutlingen

,

Bernhard Stork

¹Universitätsmedizin Göttingen

,

Hans-Peter Hebenstreit

¹Universitätsmedizin Göttingen

› Author Affiliations

Abstract

Zusammenfassung

Derzeit besteht keine pflegefachlich übereinstimmende Vorgehensweise zur Fixierung von Endotrachealtuben (ETT) bei oral intubierten erwachsenen Patienten in der Intensivtherapie. Der Tubus soll sicher und fest sitzen und dennoch den Patienten nicht verletzen, zudem muss er für Pflegende gut zu bedienen sein. Wir betrachten die Patientensicherheit und Qualitätssicherung in der Intensivpflege und geben Ihnen einen Überblick über Technik, Methoden und verschiedene Produkte der ETT-Fixierung.

Full Text

References

Literatur
1 King HK. A new device: Tube Securer. An endotracheal tube holder with integrated bite-block. Acta Anaesthesiol Sin 1997; 35: 257-259
2 Birkett KM, Southerland KA, Leslie GD. Reporting unplanned extubation. Intensive & Crit Care Nurs 2005; 21 (2) 65-75
3 Bouza C, Garcia E, Diaz M et al. Unplanned extubation in orally intubated medical patients in the intensive care unit: A prospective cohort study. Heart & Lung: J Acute & Crit Care 2007; 36 (4) 270-276
4 Krinsley J, Barone J. The Drive to Survive: Unplanned Extubation in the ICU. Chest 2005; 128 (2) 560-566
5 Lorente L. Nonpharmacologic Measures to Prevent Ventilator-Associated Pneumonia. Clin Pulm Med 2008; 15 (2) 63-70
6 Gardner A, Hughes D, Cook R et al. Best practice in stabilisation of oral endotracheal tubes: a systematic review. Aust Crit Care 2005; 18 (4) 158-65
7 Neumar RW, Otto CW, Link MS et al. American Heart Association - Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2010; 122: 729-767
8 Black JM, Cuddigan JE, Walko MA et al. Medical device related pressure ulcers in hospitalized patients. Int Wound J 2010; 7: 358-365
9 Blanc VF, Tremblay NAG. The complications of tracheal intubation: A new classification with a review of the literature. Anesthesia & Analgesia 1974; 53 (2) 202-213
10 Garcia MP, López P, Eseverri C et al. Quality of Intensive Care Nursing. Retrospective study of long-stay patients. Enferm Intensiva 1998; 9 (3) 102-108
11 Kuhn MA, Zeitler DM, Myssiorek DJ et al. Tongue Necrosis: A Rare Complication of oral intubation. Laryngoscope 2010; 120 (Suppl. 04) 159
12 Schleder B, Stott K, Lloyd R. The effect of a comprehensive oral care protocol on patients at risk for ventilator-associated pneumonia. J Advocate Health Care Spring-Summer 2002; 4: 27-30
13 Mori H, Hirasawa H, Oda S et al. Oral care reduces incidence of ventilator-associated pneumonia in ICU populations. Intensive Care Med 2006; 32: 230-236
14 Myny D, Depuydt P, Colardyn F et al. Ventilator-associated pneumonia in a tertiary care ICU: analysis of risk factors for acquisition and mortality. Acta Clin Belg 2005; 60: 114-121
15 Garcia R, Jendresky L, Colbert L et al. Reducing ventilatorassociated pneumonia through advanced oral-dental care: a 48-month study. Am J Crit Care 2009; 18: 523-532
16 Hayes J, Jones C. A collaborative approach to oral care during critical illness. Dental Health 1995; 3: 6-10
17 Stauffer JL, Petty TL. Cleft Tongue and Ulceration of Hard Palate Complications of Oral Intubation. Chest 1978; 74: 317-318
18 Weiß G. Facharbeit im Rahmen der Fachweiterbildung Intensivpflege und Anästhesie. Die Mundpflege beim beatmeten Patienten unter Berücksichtigung der Häufigkeit der Tubusumlagerung. 2005 http://gabi.noproduct.org/CD/facharbeit.pdf (Zugriff: 15.12.2010)
19 Oakes A. Pucker Up! How to Prevent Lip Pressure Ulcers from Endotracheal Tubes. NTI 2010 Poster CS102 Presentations. Am Ass Crit Care Nurs. http://www.aacn.org/DM/NTISpeakerMats/PosterDetails.aspx?AbstractID=00061195 (Zugriff: 29.10.2011)
20 Vollman K. Ask the Experts. Crit Care Nurse 2006; 26: 54
21 Lovett PB, Flaxman A, Stürmann KM et al. The insecure airway: a comparison of knots and commercial devices for securing endotracheal tubes. BMC Emerg Med 2006; 6: 7
22 Couchmana BA, Wetzig SM, Coyerc FM et al. Nursing care of the mechanically ventilated patient: What does the evidence say?. Intensive and Crit Care Nurse 2007; 23: 4-14
23 Wilpsbäumer S, Ullrich L. Intubation und Extubation – Tubusfixierung. Kap. 8.3.7, S. 142 In: Ullrich L, Stolecki D, Grünewald M, Hrsg. Intensivpflege und Anästhesie. 2. Auflage. Stuttgart: Thieme; 2010
24 Eisenberg J. Praxistipp, Tubusfixierung ohne Pflaster. PflegeIntensiv 2009; 3
25 Genzwürker H, Hinkelbein J. Fallbuch Anästhesie. Intensivmedizin und Notfallmedizin. Stuttgart: Thieme; 2005: 258-259
26 BSN medical GmbH. Deutschland: http://www.bsnmedical.de (Zugriff: 28.10.2011)
27 Lohmann & Rauscher. http://www.lohmann-rauscher.de (Zugriff: 28.10.2011)
28 Tasota FJ, Hoffman LA, Zullo TG et al. Evaluation of two methods used to stabilize oral endotracheal tubes. Heart Lung 1987; 16: 140-146
29 Kaplow R, Bookbinder M. A comparison of four endotracheal tube holders. Heart Lung 1994; 23: 59-66
30 Lev HY, Grieg I. A comparative study of oral endotracheal tube securing methods. Chest 1993; 104: 1537-1540
31 Hoffmann U. Endotracheale Intubation: Sichere Fixierung des Tubus. PflegeIntensiv 2010; 2001: 29-33
32 Clarke T, Evans S, Way P et al. A comparison of two methods of securing an endotracheal tube. Aust Crit Care 1998; 11 (2) 45-50
33 Carlsons J, Mayrose J, Krause R et al. Extubation Force: Tape versus Endotracheal Tube Holders. Ann Emerg Med 2007; 50: 686-691
34 Sung EC, Chung EM, Park JH. Custom Built Bite-Block Endotracheal Tube Holder for Prolonged Intubation. Anaesth Intensive Care 2004; 32: 278-281
35 Hoffmann CO, Swanson GA. Letters to the editor. Oral Reinforced Endotracheal Tube Crushed and Perforated from Biting. Anesth Analg 1989; 69: 552
36 Harrison P, Bacon DR, Lema MJ. Perforation and partial obstruction of an armored endotracheal tube. J Neurosurg Anesth 1995; 7 (2) 121-123
37 Kwan KM, Kok P, Koay CK. Prevention of tube occlusion caused by biting: oral bite block versus oropharyngeal airway. Anaesth Intensive Care 2000; 28: 227
38 Rello J, Koulenti D, Blot S et al. Oral care practices in intensive care units. A survey of 59 European intensive care units. Intensive Care Med 2007; 33: 1066-1070
39 Munro CL, Grap MJ. Oral health and care in the intensive care unit: state of the science. Am J Crit Care 2004; 13: 25-33
40 Scott JM, Vollman KM. Endotracheal tube and oral care. In: Lynn-McHale Wiegand DJ, Carlson KK, Eds. AACN Procedure Manual for Critical Care, Fifth Ed.. St. Louis, MO: Elsevier Saunders; 28-33
41 Miller KJ, Cornman L, Fenstermarker C et al. Utilization of Anchor Fast oral endotracheal tube fastener to reduce the incidence of lip ulcers. Respiratory Care Journal 2009 OPEN FORUM Abstracts 2009; http://www.rcjournal.com/abstracts/2009/?id=621503 (Zugriff: 10.12.2011)