Comparison of the endotracheal tube cuff pressure between a tapered- versus a cylindrical-shaped cuff after changing from the supine to the lateral flank position

Kim, Hyun-Chang; Lee, Yong–Hun; Kim, Eugene; Oh, Eun-Ah; Jeon, Young-Tae; Park, Hee Pyoung

doi:10.1007/s12630-015-0394-z

Cited by 16 publications

(41 citation statements)

References 32 publications

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“…In the previous study, it was demonstrated that the cuff pressure was higher in the TaperGuard ETT than in the cylindrical ETT after a positional change from neutral to lateral flank position although there was no difference in the degree of tube displacement between them. [10] Therefore, it was suggested that the geometry of the ETT may be responsive for the significant difference in the intracuff pressure between TaperGuard and cylindrical ETTs because there is no difference of cuff compliance between them. [10] …”

Section: Discussionmentioning

confidence: 99%

“…[10] Therefore, it was suggested that the geometry of the ETT may be responsive for the significant difference in the intracuff pressure between TaperGuard and cylindrical ETTs because there is no difference of cuff compliance between them. [10] …”

Section: Discussionmentioning

confidence: 99%

“…[8,9] However, recently, it was reported that the cuff pressure of a TaperGaurd ETT significantly increased after a positional change from the supine to the lateral flank position, compared to that of a cylindrical ETT. [10] …”

Section: Introductionmentioning

confidence: 99%

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Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery

2017

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Background:Positional change affects the cuff pressure of an endotracheal tube (ETT) in treacheally intubated patients. We compared the cuff pressure of a TaperGuard ETT and a cylindrical ETT after lateral rotation of head during middle ear surgery.Methods:Fifty-two patients aged 18–70 years underwent a tympanomastoidectomy under general anesthesia were randomly allocated to receive endotracheal intubation with cylindrical (group C, n = 26) or TaperGuard ETTs (group T, n = 26). After endotracheal intubation, the ETT cuff pressure was set at 22 cmH2O in the neutral position of head. After lateral rotation of head, the cuff pressure was measured again and readjusted to 22 cmH2O. In addition, the change of distance from the carina to the tip of the ETT was measured before and after the positional change. The incidence of cough, sore throat, and hoarseness was assessed at 30 minutes, 6 hours, and 24 hours after surgery.Results:There was no difference in demographic data between groups. After lateral rotation of head, the cuff pressure significantly increased in group T (11.9 ± 2.3 cmH2O) compared with group C (6.0 ± 1.9 cmH2O) (P < 0.001). The incidence of a cuff pressure >30 cmH2O was higher in group T (96.2%) than in group C (30.8%) (P < 0.001). In addition, the degree of displacement of an ETT was greater in group T (11.0 ± 1.7 mm) than in group C (7.2 ± 2.6 mm) (P < 0.001). The overall incidences of postoperative sore throat, hoarseness, and cough at 30 minutes, 6 hours, and 24 hours after surgery were comparable between two groups.Conclusion:The cuff pressure was higher in the TaperGuard ETT than in the cylindrical ETT after positional change of head from neutral to lateral rotation. In addition, after a positional change, the extent of displacement of ETT was greater in the TaperGuard ETT than in the cylindrical ETT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery

2017

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“…Several studies have demonstrated alterations in the cuff pressure of the ETT in response to repositioning of the patient. The cuff pressure of single-lumen ETTs has been found to change when patients undergoing general surgery are moved from the supine position to the prone12 or lateral frank13 position and when the head is shifted from the neutral position to another position 14 15. Such changes in cuff pressure have been reported to occur primarily because of displacement of the tube within the trachea 13.…”

Section: Introductionmentioning

confidence: 99%

Effect of lateral positioning on the bronchial cuff pressure of a left-sided double-lumen endotracheal tube during thoracic surgery: study protocol for a prospective observational study

Kim

Byun

2019

BMJ Open

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IntroductionCorrect pressure is important when using a double-lumen endotracheal tube (DLT), especially in thoracic surgery. An inadequate bronchial cuff pressure (BCP) can cause air leak and interfere with visualisation of the surgical field, whereas an excessive pressure BCP can lead to cuff-related complications. Based on several reports that cuff pressure could alter after a positional change when using an endotracheal tube, we hypothesise that a change from the supine position to the lateral decubitus position, which is essential for thoracic surgery, would affect the BCP of the DLT.Methods and analysisThis prospective, single-centre, observational study will enrol 74 patients aged 18–70 years undergoing elective lung surgery from September 2018 to April 2019. The primary outcome will be the change in the ‘initially established BCP’ (maximum BCP not exceeding 40 cm H2O with no air leak in the supine position) after lateral decubitus positioning. BCP and air leak will be assessed in each patient position during inflation of the cuff with air in 0.5 mL increments from 0 to 3 mL. Secondary outcomes will include the incidence of BCP exceeding 40 cm H2O after the initial established value and that of a change in the smallest bronchial cuff volume without air leak after a change to the lateral position. The relationship between the change in BCP and airway pressure, compliance and body mass index after lateral positioning will be investigated.Ethics and disseminationThe study will be conducted in accordance with the Declaration of Helsinki and supervised by the Daegu Catholic University Medical Center institutional review board (study approval number CR-18–111). All patients will receive information about the study and will need to provide written informed consent before enrolment. The results will be presented at an international meeting and published in a peer-reviewed journal.Trial registration numberNCT03656406; Pre-results.

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“…The intracuff pressure is affected by many factors, such as head and neck positioning, material and type of the ETT cuff used, and the concomitant anesthetic gas [7][8][9][10][11][12]. Among these, nitrous oxide (N2O) diffuses into the ETT cuff, increasing the intracuff pressure and the risk of tracheal trauma [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the endotracheal tube intracuff pressure with cylindrical and tapered cuffs during nitrous oxide exposure: a randomized single-blinded clinical study

Park

Kim

2017

Anesth Pain Med

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Comparison of the endotracheal tube cuff pressure between a tapered- versus a cylindrical-shaped cuff after changing from the supine to the lateral flank position

Cited by 16 publications

References 32 publications

Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery

Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery

Effect of lateral positioning on the bronchial cuff pressure of a left-sided double-lumen endotracheal tube during thoracic surgery: study protocol for a prospective observational study

Comparison of the endotracheal tube intracuff pressure with cylindrical and tapered cuffs during nitrous oxide exposure: a randomized single-blinded clinical study

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