Endotracheal Tube Seal and Suction Performance in a Novel Biorealistic Tracheal Model

Rozycki, Sarah K.; Dixon, Fredrick P; Yopp, Melissa A; Maxvold, Norma J.; Rubin, Bruce K.

doi:10.4187/respcare.03799

Cited by 6 publications

(5 citation statements)

References 28 publications

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“…The sealing pressures in our study were lower than the cuff pressure of 20–30 cm H 2 O (14.7–22.1 mm Hg) commonly used in clinical practice. The median occlusion cuff pressures of 9 mm Hg for tapered cuffs and 11 mm Hg for cylindrical cuffs, needed for a leak-free seal, were higher than the pressures found in a viscoelastic model of the trachea ( 36 ). The model predicted that cuffs with different designs required a pressure of only 8.8 mm Hg (12 cm H 2 O) for a complete air seal ( 36 ); the findings for tapered cuffs in this study are consistent with predicted values from simulated models ( 36 ).…”

Section: Discussionmentioning

confidence: 66%

“…The median occlusion cuff pressures of 9 mm Hg for tapered cuffs and 11 mm Hg for cylindrical cuffs, needed for a leak-free seal, were higher than the pressures found in a viscoelastic model of the trachea ( 36 ). The model predicted that cuffs with different designs required a pressure of only 8.8 mm Hg (12 cm H 2 O) for a complete air seal ( 36 ); the findings for tapered cuffs in this study are consistent with predicted values from simulated models ( 36 ). Further, the safety of our occlusion pressures was confirmed in our human study participants.…”

Section: Discussionmentioning

confidence: 66%

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A Tapered Cuff Tracheal Tube Decreases the Need for Cuff Pressure Adjustment After Surgical Retraction During Anterior Cervical Spine Surgery: A Randomized Controlled, Double-Blind Trial

Tan

Tsai

et al. 2022

Front. Med.

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BackgroundSurgical retraction to expose the vertebrae during anterior cervical spine surgery increases tracheal tube cuff pressure and may worsen postoperative sore throat and dysphonia. This randomized double-blind study investigated the effect of cuff shape on intraoperative cuff pressure and postoperative sore throat and dysphonia.MethodsEighty patients were randomized to tracheal intubation with a tapered cuff or a conventional cylindrical high-volume low-pressure cuff (control) during anesthesia. Intraoperative cuff pressures were compared. The primary outcome was the incidence of pressure adjustment needed when the cuff pressure increased to > 25 mm Hg after surgical retraction. The secondary outcome was the incidence of postoperative sore throat and dysphonia.ResultsThe incidence of pressure adjustment after surgical retraction was significantly lower in the tapered group than in the control group (13% vs. 48%; P = 0.001; relative risk reduction, 74%). The median [interquartile range (IQR)] cuff pressure (mm Hg) was significantly lower for the tapered cuff than for the control cuff before surgical retraction [9 (7–12) vs. 12 (10–15); P < 0.001] and after retraction [18 (15–23) vs. 25 (18–31); P = 0.007]. The median (IQR) postoperative dysphonia score assessed by a single speech-language pathologist was lower in the tapered group than in the control group [4 (3–6) vs. 5.5 (5–7); P = 0.008].ConclusionA tapered cuff tracheal tube decreased the need for the adjustment of cuff pressure after surgical retraction during anterior cervical spine surgery, thereby avoiding intraoperative pressure increase. It also has a better outcome in terms of dysphonia.Clinical Trial Registration[www.clinicaltrials.gov], identifier [NCT04591769].

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 66%

A Tapered Cuff Tracheal Tube Decreases the Need for Cuff Pressure Adjustment After Surgical Retraction During Anterior Cervical Spine Surgery: A Randomized Controlled, Double-Blind Trial

Tan

Tsai

et al. 2022

Front. Med.

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“…Additionally, the compliance of the trachea (in this case the trachea model) may play a role, as is roughly indicted in the large difference of volume of air necessary to inflate the cuffs in our study to 20 cm H 2 O inside and outside the used tracheal model. Similarly, the sealing cuff pressure was recently shown to be lower than mostly reported in an assumingly rather biorealistic model …”

Section: Discussionmentioning

confidence: 74%

Endotracheal tube cuff pressure changes during manual cuff pressure control manoeuvres: An in‐vitro assessment

Aeppli

Lindauer

Steurer

et al. 2018

Acta Anaesthesiol Scand

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“…Artificial mucus was created based on a study published by Rozycki et al [ 20 ] using Polyox water-soluble resin N-750 solution (Dow Chemicals, Woodbury, New Jersey) at a 2.5% concentration. The artificial mucus was made by heating 200 mL of water to 95–97°C and adding 2.5 g of Polyox per 100 mL of water.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of a novel endotracheal tube suctioning system incorporating an inflatable sweeper

Davies¹,

Huang²,

MacIntyre³

2021

Can J Respir Ther

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Introduction: Accumulation of secretions in an endotracheal tube can increase the resistance to flow resulting in an increased patient work of breathing when the patient is interacting with the ventilator. Retained secretions can also serve as an infection risk. Standard suction catheters are limited in their ability to keep the lumen of the endotracheal tube clear. A novel closed-suction catheter has been introduced that incorporates a balloon at its distal end that, when inflated, physically scrapes secretions out of the endotracheal tube (CleanSweep catheter (CSC), Teleflex, Morrisville NC). We hypothesized that the CSC would be more efficient at removing secretions from inside the endotracheal tube than a standard suction catheter (SSC). Methods: We performed a bench study examining resistive pressures across different sizes of endotracheal tubes when cleaned by the CSC as compared with an SSC. This study was followed by a prospective crossover study again comparing the CSC with an SSC in intubated intensive care unit patients receiving mechanical ventilation and requiring frequent suctioning. Results: For the bench study the CSC was significantly better in reducing airway resistive pressures (P < 0.001). In the prospective crossover study the CSC over 2 h also removed significantly more secretions than the SSC (P < 0.05). Conclusion: Both our bench and crossover clinical study demonstrated improved clearance of secretions with the CSC vs an SSC. Further research is needed to ascertain the clinical outcome benefits of enhanced secretion removal.

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Endotracheal Tube Seal and Suction Performance in a Novel Biorealistic Tracheal Model

Cited by 6 publications

References 28 publications

A Tapered Cuff Tracheal Tube Decreases the Need for Cuff Pressure Adjustment After Surgical Retraction During Anterior Cervical Spine Surgery: A Randomized Controlled, Double-Blind Trial

A Tapered Cuff Tracheal Tube Decreases the Need for Cuff Pressure Adjustment After Surgical Retraction During Anterior Cervical Spine Surgery: A Randomized Controlled, Double-Blind Trial

Endotracheal tube cuff pressure changes during manual cuff pressure control manoeuvres: An in‐vitro assessment

Evaluation of a novel endotracheal tube suctioning system incorporating an inflatable sweeper

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