A newly developed tracheal tube offering ‘pressurised sealing’ outperforms currently available tubes in preventing cuff leakage

Spapen, Herbert D.; Suys, E.; Diltoer, Marc; Stiers, Wim; Desmet, Geert; Honoré, Patrick M.

doi:10.1097/eja.0000000000000493

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…Other tubes with more-rigid tube shafts or conical cuffs or cuffs made with polyurethane material were also used [32]. Therefore, our results may not be applicable for different tube types.…”

Section: Discussionmentioning

confidence: 99%

Effects of Head and Neck Position on Nasotracheal Tube Intracuff Pressure: A Prospective Observational Study

Kim

Jang

Kim

et al. 2021

JCM

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To prevent endotracheal tube-related barotrauma or leakage, the intracuff pressure should be adjusted to 20–30 cm H2O. However, changes in the nasotracheal tube intracuff pressure relative to neck posture are unclear. In this study, we investigated the effect of head and neck positioning on nasotracheal tube intracuff pressure. Fifty adult patients with nasotracheal tubes who were scheduled for surgery under general anesthesia were enrolled. Following intubation, intracuff pressure was measured by connecting the pilot balloon to a device that continuously monitors the intracuff pressure. Subsequently, the intracuff pressure was set to 24.48 cm H2O (=18 mmHg) for the neutral position. We recorded the intracuff pressures based on the patients’ position during head flexion, extension, and rotation. The initial intracuff pressure was 42.2 cm H2O [29.6–73.1] in the neutral position. After pressure adjustment in the neutral position, the intracuff pressure was significantly different from the neutral to flexed (p < 0.001), extended (p = 0.003), or rotated (p < 0.001) positions. Although the median change in intracuff pressure was <3 cm H2O when each patient’s position was changed, overinflation to >30 cm H2O occurred in 12% of patients. Therefore, it is necessary to adjust the intracuff pressure after tracheal intubation and each positional change.

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Section: Discussionmentioning

confidence: 99%

Effects of Head and Neck Position on Nasotracheal Tube Intracuff Pressure: A Prospective Observational Study

Kim

Jang

Kim

et al. 2021

JCM

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“…A positive pressure, created and regulated by an external source, is continuously presented to the intercuff space (ICS) and propels secretions upwards towards the oropharynx. We previously demonstrated superiority of this ETT above currently commercialized ETTs in preventing leakage of secretions in a vertical syringe model and in an artificial trachea [4]. The current study intends to investigate this novel "pressurized sealing" concept in a cohort of mechanically ventilated critically ill patients.…”

Section: Introductionmentioning

confidence: 98%

An endotracheal tube providing “pressurized sealing” prevents fluid leakage in mechanically ventilated critically ill patients: a pilot study

et al. 2019

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Microaspiration of bacteriologically contaminated oropharyngeal secretions alongside the cuff of an endotracheal tube (ETT) is a key mechanism for development of ventilator-associated pneumonia. We have constructed a prototype double-cuffed ETT equipped with a supplemental port in-between the cuffs through which continuous positive airway pressure (CPAP) is delivered. Pressure in the intercuff space propels secretions upwards and produces 100% tracheal sealing in an in vitro model. We conducted a 24 h study to investigate the sealing effect of this ETT in 12 critically ill mechanically ventilated patients. Methylene blue, instilled through a bronchoscope on top of the proximal cuff, was used as leakage tracer. Fiberoptic visualisation of the trachea was performed 1 h and 24 h thereafter. Leakage was confirmed if blue dye was detected on the tracheal mucosa beyond the tip of the ETT. In no patient, dye passed by the cuffs during the study period. Presence of the ETT did not interfere with ventilator settings, patient mobilization, physiotherapy, and technical acts. Overall, pressures in the intercuff space remained between 10 and 15 cmH 2 O. Excessive pressure swings were swiftly corrected by the CPAP system. A double-cuffed ETT, offering "pressurized sealing" of the trachea, safely and effectively prevented leakage during 24 h mechanical ventilation.

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Immobilization of silver nanoparticles at varying concentrations on segments of polyvinyl chloride manufactured endotracheal tubes

Arias,

García,

Agudelo

et al. 2024

Materials Today Communications

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A newly developed tracheal tube offering ‘pressurised sealing’ outperforms currently available tubes in preventing cuff leakage

Abstract: A 'pressure seal' incorporated in a double-cuffed tracheal tube prevented fluid passage into the lower airways. Clinically, this may translate into absence of inflow of bacteriologically contaminated secretions into the lungs and thus a lower incidence of ventilator-associated infection.

Cited by 4 publications

References 24 publications

Effects of Head and Neck Position on Nasotracheal Tube Intracuff Pressure: A Prospective Observational Study

Effects of Head and Neck Position on Nasotracheal Tube Intracuff Pressure: A Prospective Observational Study

An endotracheal tube providing “pressurized sealing” prevents fluid leakage in mechanically ventilated critically ill patients: a pilot study

Immobilization of silver nanoparticles at varying concentrations on segments of polyvinyl chloride manufactured endotracheal tubes

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