2014
DOI: 10.4266/kjccm.2014.29.1.3
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The Effect of Positive End-Expiratory Pressure on Air Leakage: Comparison of Cuff Designs

Abstract: Background:Recently developed taper-shaped cuffs (TG cuffs) of endotracheal tubes (ETTs) are known to have a more potent sealing effect than cylindrical high-volume low-pressure cuffs (HL cuffs) of conventional ETTs. The aim of this study was to compare TG cuffs with HL cuffs of ETTs in a bench-top model with regard to air leakage under various positive end-expiratory pressures (PEEP). Methods: HL cuffs and TG cuffs made from PVC were included (HL group vs. TG group). A model trachea with an internal diameter … Show more

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Cited by 2 publications
(3 citation statements)
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“…In vitro studies have demonstrated that the cuff is protective against fluid leakage, largely owing to the proximal large diameter and distal small diameter, allowing the geometry to fit into the trachea to form a seal with minimal folds. [26][27][28] The locations in which the cuff contacts the trachea are presumed to be the most vulnerable due to transmural pressure injury. While the proximal part of the LVLP cuff is in complete contact with the tracheal wall, it has shown less injury than the middle and distal portion.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…In vitro studies have demonstrated that the cuff is protective against fluid leakage, largely owing to the proximal large diameter and distal small diameter, allowing the geometry to fit into the trachea to form a seal with minimal folds. [26][27][28] The locations in which the cuff contacts the trachea are presumed to be the most vulnerable due to transmural pressure injury. While the proximal part of the LVLP cuff is in complete contact with the tracheal wall, it has shown less injury than the middle and distal portion.…”
Section: Discussionmentioning
confidence: 99%
“…One interesting finding was that the LVLP tracheostomy cuff resulted in less injury in the proximal cuff area compared to the HVLP cuff, despite the larger diameter of the tapered design. In vitro studies have demonstrated that the cuff is protective against fluid leakage, largely owing to the proximal large diameter and distal small diameter, allowing the geometry to fit into the trachea to form a seal with minimal folds 26‐28 . The locations in which the cuff contacts the trachea are presumed to be the most vulnerable due to transmural pressure injury.…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, PEEP may actually distend the trachea and the upper airway, and any increase in diameter will decrease resistance exponentially and may increase leak. Usually uncuffed tubes are used in neonates, but higher PEEP may even increase the leakage when cuffed tubes are used [22]. …”
Section: Discussionmentioning
confidence: 99%