Pressures on endotracheal tube cuffs

Black, Andy; Seegobin, R.D.

doi:10.1111/j.1365-2044.1981.tb10286.x

Cited by 32 publications

(23 citation statements)

References 26 publications

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“…In this case, the cuff is confined within the trachea which is a semirigid container whose shape is relatively uniform in comparison with the pharynx. However, even under these circumstances, measurement of the pressure exerted on the tracheal mucosa is complex, and still not clearly understood [4]. The pharynx is both more complex in shape, and far more distensible than the trachea.…”

Section: Discussionmentioning

confidence: 99%

The effect of nitrous oxide on laryngeal mask cuff pressure

Lumb

Wrigley

1992

Anaesthesia

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In v i m and in vivo studies A. B. LUMB AND M.W. WRIGLEY SummaryWe have studied the effect of nitrous oxide on the cufpressure o f a laryngeal mask both in vitro and in vivo. In laboratory tests. we showed that nitrous oxide and carbon dioxide diffuse across the cuff wall much more rapidly than nitrogen and oxygen. Diflkring partial pressures of these gases across the cuff wall therefore give rise to changes in volume and pressure within the cuff. We then studied 18 patients undergoing general anaesthesia with nitrous oxide, and found a consistent and linear increase in cufl pressure in all patients. After 30 min. the mean pressure had increased by 30 mmHg, and there was approximately 10% nitrous oxide in the cuff: It is dificult to relate these findings to pressure on pharyngeal structures, but methods of limiting the rise in intracufl pressure are discussed.

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Section: Discussionmentioning

confidence: 99%

The effect of nitrous oxide on laryngeal mask cuff pressure

Lumb

Wrigley

1992

Anaesthesia

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“…The endotracheal cuffs were inflated to 25 cm H20 initially, by which point clinical seal had been effected. The Lanz tubes generated a pressure of 27 4 At the end of the operation the cuff-trachea contact area was reexamined and photographed before reversal of the relaxant.…”

Section: Methodsmentioning

confidence: 99%

Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs.

Seegobin¹,

Hasselt²

1984

BMJ

535

382

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Large volume, low pressure endotracheal tube cuffs are claimed to have less deleterious effect on tracheal mucosa than high pressure, low volume cuffs. Low pressure cuffs, however, may easily be overinflated to yield pressures that will exceed capillary perfusion pressure. Various large volume cuffed endotracheal tubes were studied, including Portex Profile, Searle Sensiv, Mallinkrodt Hi-Lo, and Lanz. Tracheal mucosal blood flow in 40 patients undergoing surgery was assessed using an endoscopic photographic technique while varying the cuff inflation pressure. It was found that these cuffs when overpressurised impaired mucosal blood flow.This impairment of tracheal mucosal blood flow is an important factor in tracheal morbidity associated with intubation. Hence it is recommended that a cuff inflation pressure of 30 cm H20 (22 mm Hg) should not be exceeded.

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“…[1][2][3] The cylindrical cuff has a diameter equivalent to 150% of the tracheal diameter and is prone to fluid leakage, due to the presence of folds. 2,3 The newly developed tapered cuff has a diameter that is 120% of the tracheal diameter and a taper angle of 14 for proper sealing.…”

Section: Discussionmentioning

confidence: 99%

“…Cuffs require proper sealing for positive ventilation, and are maintained using minimal pressure and volume to protect the perfusion of tracheal mucosa, minimizing airway complications such as oropharyngeal aspiration, sore throat and tracheal stenosis. [1][2][3] In order to prevent oropharyngeal aspiration, which often resulted from leakage occurring with the conventional cylindrical cuff, a tapered cuff has been developed. 4,5 This cuff has a variable cuff diameter (which is 120% of the tracheal diameter at its widest point) a taper angle of 14 , and creates a 'sealing zone' where the cuff diameter corresponds to the tracheal diameter.…”

Section: Introductionmentioning

confidence: 99%

Changes in cuff pressure and position of cylindrical-cuff and tapered-cuff tracheal tubes during laparoscopic abdominal surgery

et al. 2015

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Objectives: To evaluate changes in cuff pressure and position of tapered-cuff and cylindrical-cuff tracheal tubes (TTs) during laparoscopic cholecystectomy; to compare the frequency of endobronchial intubation and airway complaints with the two types of TT. Methods: Patients were randomly assigned to intubation with a TT with a cylindrical cuff (group C) or a tapered cuff (group T). Anaesthesia was maintained with sevoflurane, O 2 and N 2 O after intubation. TT cuffs were inflated to 20 cm H 2 O; changes in cuff pressure and volume were measured up to 30 min after the start of N 2 O use. Distance between the TT tip and the carina was measured before and after pneumoperitoneum and position change. Frequency of sore throat, dysphagia and hoarseness in the two groups was recorded. Results: Cuff volume and pressure were significantly lower in group T than in group C (n ¼ 32 per group). Cuff pressure and volume significantly increased 30 min after start of N 2 O use in both groups. Distance from the TT tip to the carina decreased during surgery in both groups. There were no cases of endobronchial intubation, and there were no between-group differences in the frequency of airway complaints. Conclusions: The tapered cuff was associated with a smaller change in cuff pressure during laparoscopic cholecystectomy than the cylindrical cuff, and therefore may be associated with increased preservation of tracheal mucosal perfusion.

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Pressures on endotracheal tube cuffs

Cited by 32 publications

References 26 publications

The effect of nitrous oxide on laryngeal mask cuff pressure

The effect of nitrous oxide on laryngeal mask cuff pressure

Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs.

Changes in cuff pressure and position of cylindrical-cuff and tapered-cuff tracheal tubes during laparoscopic abdominal surgery

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