Pressure on the tracheal mucosa from cuffed tubes.

Abstract

Work is needed on the place of such herds in the ecology of campylobacters, the endemicity of the infection within herds, and the factors leading to contamination of milk.We believe that the evidence points to thermophilic Campylobacter sp being an occasional but important contaminant of milk, which, under certain circumstances, may give rise to considerable outbreaks of enteritis in man. As with salmonella contamination it is probably only important where unpasteurised milk is consumed, but so long as there is a public demand for unpasteurised milk and the law allows such milk to be widely distributed, we believe that there is a risk that outbreaks will continue to occur.

Excessive endotracheal tube cuff pressure: Is there any difference between emergency physicians and anesthesiologists?

“…During cuffed intubation, excessive pressure on the tracheal mucosa, more than mean capillary perfusion pressure of the mucosa, leads to tracheal damage and pathologic changes such as ischemia, inflammation, ulceration, tracheal necrosis or stenosis and tracheoesophageal fistula. (4)(5)(6)(7)(8) Endoscopic studies have shown a relationship between elevated cuff pressures and tracheal lesions (5) and it is reported that respiratory complications such as cough, sore throat, hoarseness, and bloodstreaked expectoration would occur even following short duration intubations (1-3 hours). (9) Although some articles propose a pressure as high as 40 cmH 2 O of ETT cuff pressure (which is equal to tracheal capillary pressure) for initiation of mucosal damage, (1,10) it is recommended to maintain the cuff pressure within a narrow ideal range of 20 to 30 cmH 2 O to prevent complications.…”

A canine model of tracheal stenosis induced by cuffed endotracheal intubation

“…Julian et al . showed that when the cuff pressure is maintained at 100 mmHg for 4 hr, the inflammation and injury penetrate down to tracheal cartilage27. Histopathological analysis suggested that damage and destruction of the tracheal perichondrium and cartilage are key factors for tracheal stenosis and indicators of poor prognosis2829.…”

An in vitro study of the compliance of paediatric tracheal tube cuffs and tracheal wall pressure

“…In previous in vitro and in vivo studies it has been shown that the pressures exerted by tube cuffs onto the C-shaped tracheal wall are different in the anterior, posterior or lateral part of the trachea [24,25].…”