关键词: 肥胖患者；人工气道；气囊压力；衰减；重症患者；安全

Abstract: Objective: To explore the dynamic attenuation trend of artificial airway cuff pressure in obese patients through continuous monitoring, aiming to provide reference for clinical nursing staff to optimize and regulate the cuff pressure of artificial airways in obese patients, and improve the safety and effectiveness of the cuff pressure of artificial airways management. Methods: Obese patients (BMI≥28.0 kg/m2) who underwent mechanical ventilation in the ICU of a tertiary grade A hospital from December 2024 to April 2025 were recruited as the research participants by purposive sampling method. According to the maximum limit of artificial airway cuff pressure recommended by the guidelines, the pressure was adjusted to 30 cmH2O. The cuff pressure monitoring gauge was used to monitor and record the actual pressure every hour. Using the continuous monitoring time of the patients' cuff pressure as the variable and <25 cmH2O as the outcome, the Kaplan-Meier curve for the monitoring of artificial airway cuff pressure in obese patients was drawn, and the changes in artificial airway cuff pressure over time in obese patients were observed. Results: The cuff pressure initially set at 30 cmH2O dropped below the safe range in 10.17% of patients after 1 hour, and the cumulative proportion reached 57.63% after 4 hours. After 8 hours, only 23.73% of patients maintained the cuff pressure at 25 cmH2O. The results showed that the median time for the patients' cuff pressure to be <25 cmH2O was 4 hours (95% CI: 2.8-5.2). Conclusion: The attenuation rate of cuff pressure in obese patients is relatively fast. It is recommended to increase the monitoring frequency in clinical work or use continuous cuff pressure monitoring equipment for dynamic management to ensure that the pressure remains within a safe range.

Key words: obese patients; artificial airway; cuff pressure; attenuation; critical patients; safety