A Mathematical Model of Differential Tracheal Tube Cuff Pressure: Effects of Diffusion and Temperature

Atlas, Glen

doi:10.1007/s10877-005-1626-5

Cited by 13 publications

(10 citation statements)

References 24 publications

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“…24 Atlas in 2005 provided a mathematical model for the relationship between body temperature and cuff pressure. 33 In 2014, Sharifi et al showed that a high percentage of cuffs had excessive intracuff pressures. They also showed that there is no specific relationship between cuff pressure and body temperature.…”

Section: Discussionmentioning

confidence: 99%

Comparison of tracheal tube cuff pressure with two technique: fixed volume and minimal leak test techniques

Sanaie

Rahmani

Chokhachian

et al. 2019

J Cardiovasc Thorac Res

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Introduction: There is a correlation between endotracheal cuff pressure and airway complication; therefore, cuff pressure measurement is of an essential importance. The gold standard technique is measuring the cuff pressure by a calibrated manometer. However, there are several methods that injects air into balloon pilot and measures the cuff pressure. The aim of this study is to compare the tracheal cuff pressure measurement by two methods: fixed volume and minimal leak test (MLT). Methods: This descriptive study was performed at the emergency department on 110 patients. Patients were randomized into two groups. For one group, fixed volume technique and for the other group MLT was used. Results: Mean cuff pressure was 46.07±23.54 cmH2O in the fixed volume group and 33.72±9.14 cmH2O in the MLT group (P=0.05) which is significantly higher in the fixed volume group (P=0.028). In addition, 56.4% and 78.2% of the subjects had normal cuff pressure in the fixed volume group and MLT group, respectively; indicating a significantly higher rate in MLT group (P=0.025). Conclusion: Both techniques cause above normal intracuff pressure; however, MLT produces more acceptable pressure than fixed volume. It seems that the volume of 10 cc produces high pressures; therefore, fixed values may yield more appropriate results in lower volumes.

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Section: Discussionmentioning

confidence: 99%

Comparison of tracheal tube cuff pressure with two technique: fixed volume and minimal leak test techniques

Sanaie

Rahmani

Chokhachian

et al. 2019

J Cardiovasc Thorac Res

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show abstract

“…Only max imum readings were recorded. The mean (standard deviation (SD)) Pcuff of all patients for T 0 was 25.3 (6.9) cmH 2 O; for T 6 25.9 (8.7) cmH 2 O and for T 12 24 time was spent in the low-pressure range (<20 cmH 2 O), 83% in the target pressure range (20 -30 cmH 2 O) and 5% in the highpressure range (>30 cmH 2 O) ( Fig. 1).…”

Section: Resultsmentioning

confidence: 97%

“…Such factors include patient airway suctioning, coughing, struggling, neck movements, modes of ventilation and temperature. [10][11][12] Therefore, it is vitally important that Pcuff is diligently maintained within the recommended range.…”

mentioning

confidence: 99%

Variations in endotracheal tube cuff pressure: Is 8-hourly monitoring enough?

Memela

Gopalan²

2014

S Afr J Crit Care

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Background. Most patients adm itted to an intensive care unit (ICU) for mechanical ventilation require endotracheal intubation. Cuffed endotracheal tubes (ETTs) are utilised as they provide a better seal to facilitate ventilation and minimise aspiration. Complications due to overinflation or underinflation o f the cuff may occur. Neither the frequency o f in te rm itte nt cuff pressure (Pcuff) measurement nor the advantage o f continuous Pcuff m onitoring has been clearly established.Objective. To determ ine deviations in ETT Pcuff from the recommended range during the intervals between routine thrice-daily Pcuff measurements in adult ICU patients. Our key objective was to identify the extent and cause o f ETT Pcuff changes during these intervals. In addition, we attem pted to demonstrate the failure o f routine thrice-daily Pcuff m onitoring to detect the large variation in Pcuff o f patients throu gh ou t the day.Methods. This prospective, observational study was conducted in the King Edward VIII Hospital ICU, Durban, KwaZulu-Natal Province, South Africa. Ethical and institutional approval was obtained. Consent was obtained from patients' next o f kin. Interm ittent Pcuff was recorded using mechanical manometers, and continuous measurements using pressure transducers. Results. Thirty-five critically ill adult patients were enrolled. The mean study tim e was 11.1 h. The mean Pcuff was 25.6 (standard deviation 7.1) cmH20 for the interm ittent group and 26.6 (8.7) cmH20 for the continuous group.The interm ittent pressure measurements were in the low-pressure range (<20 cmH20) 12% of the tim e compared w ith 83% in the target pressure range (20 -30 cmH20) and 5% in the high-pressure range (>30 cmH20). For continuous pressures, 13% o f the tim e was spent in the low-pressure range, 64% in the target pressure range, and 23% in the high-pressure range. For the entire study, 588 events causing Pcuff alterations were recorded. Conclusion. Continuous m onitoring o f Pcuff indicated that the endotracheal Pcuff varied extensively during mechanical ventilation in critically ill patients, such variation being noted both between patients and w ithin individual patients. Variations in individual patients occurred both during intrinsic patient activities and those of ICU personnel as part of routine patient maintenance. Interm ittent m onitoring may not detect these variations. Continuous m onitoring of Pcuff during mechanical ventilation in ICUs is thus recommended for all patients.S

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“…There is a linear relationship between the measured intracuff pressure and the volume of air inflated into the cuff [24,25]. The pressure inside the ETT cuff is known to be affected by several factors; including lateral wall pressure, duration of ETT placement [4], patient position [26], head position [27], cuff position [28], cuff volume, temperature [29], use of nitrous oxide [30] and other lesser known factors. Deliberate or inadvertent movement of the ETT may also affect cuff pressure by creating folds in the cuff letting pooled secretions pass downwards.…”

Section: Importance Of Measuring Ett Intracuff Pressurementioning

confidence: 99%

Measuring endotracheal tube intracuff pressure: no room for complacency

Kumar

Seet

Zundert

2020

J Clin Monit Comput

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Tracheal intubation constitutes a routine part in the care of critically ill and anaesthetised patients. Prolonged use of endotracheal with inflated cuff is one of the major multifactorial causes of complications. Both under-inflation and over-inflation of cuff are associated with complications. Despite known problems, regular measurement of cuff pressure is not routine, and it is performed on an ad hoc basis.

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A Mathematical Model of Differential Tracheal Tube Cuff Pressure: Effects of Diffusion and Temperature

Cited by 13 publications

References 24 publications

Comparison of tracheal tube cuff pressure with two technique: fixed volume and minimal leak test techniques

Comparison of tracheal tube cuff pressure with two technique: fixed volume and minimal leak test techniques

Variations in endotracheal tube cuff pressure: Is 8-hourly monitoring enough?

Measuring endotracheal tube intracuff pressure: no room for complacency

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