Tracheal rupture after endotracheal intubation - A report of three cases -

Lim, Hyungsun; Kim, Jung Hee; Kim, Deokkyu; Lee, Jeongwoo; Son, Ji Seon; Kim, Dong Chan; Ko, Seonghoon

doi:10.4097/kjae.2012.62.3.277

Cited by 47 publications

(55 citation statements)

References 15 publications

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“…ETT cuff pressure below 20 cmH 2 O is a risk factor of ventilator associated pneumonia [ 1 , 2 ]. However, over-inflation of the ETT cuff can cause a serious injury and affect blood flow to the tracheal mucosa [ 3 ], resulting in tracheal stenosis, tracheoesophageal fistula, or tracheal rupture [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The changes of endotracheal tube cuff pressure by the position changes from supine to prone and the flexion and extension of head

Kim

Jeon

Son

et al. 2015

Korean J Anesthesiol

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BackgroundThe proper cuff pressure is important to prevent complications related to the endotracheal tube (ETT). We evaluated the change in ETT cuff pressure by changing the position from supine to prone without head movement.MethodsFifty-five patients were enrolled and scheduled for lumbar spine surgery. Neutral angle, which was the angle on the mandibular angle between the neck midline and mandibular inferior border, was measured. The initial neutral pressure of the ETT cuff was measured, and the cuff pressure was subsequently adjusted to 26 cmH2O. Flexed or extended angles and cuff pressure were measured in both supine and prone positions, when the patient's head was flexed or extended. Initial neutral pressure in prone was compared with adjusted neutral pressure (26 cmH2O) in supine. Flexed and extended pressure were compared with adjusted neutral pressure in supine or prone, respectively.ResultsThere were no differences between supine and prone position for neutral, flexed, and extended angles. The initial neutral pressure increased after changing position from supine to prone (26.0 vs. 31.5 ± 5.9 cmH2O, P < 0.001). Flexed and extended pressure in supine were increased to 38.7 ± 6.7 (P < 0.001) and 26.7 ± 4.7 cmH2O (not statistically significant) than the adjusted neutral pressure. Flexed and extended pressure in prone were increased to 40.5 ± 8.8 (P < 0.001) and 29.9 ± 8.7 cmH2O (P = 0.002) than the adjusted neutral pressure.ConclusionsThe position change from supine to prone without head movement can cause a change in ETT cuff pressure.

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Section: Introductionmentioning

confidence: 99%

The changes of endotracheal tube cuff pressure by the position changes from supine to prone and the flexion and extension of head

Kim

Jeon

Son

et al. 2015

Korean J Anesthesiol

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“…In ation of the endotracheal tube cuff to the correct pressure is one of the elements in properly conducted intubation. Carrying out the procedure correctly is di cult when it is done using a syringe [2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…Research in other countries has shown that assessment of cuff in ation using the palpation technique is relatively ineffective and rarely results in correct cuff in ation. Experienced paramedic specialists using the palpation technique to assess the amount of air in the cuff during intensive care conduct the procedure correctly in less than 30% of cases [2][3][4][5]. It has been proven that during palpation assessment, the cuff seal is overin ated, even to as high as 100 cm H2O [4].…”

Section: Introductionmentioning

confidence: 99%

Endotracheal tube cuff pressure – how fast paramedics can learn the optimal inflation? - comparison of different methods

Ilczak

Ćwiertnia

Białoń

et al. 2020

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Background Tracheal intubation is the optimal method for opening up the airways. Performed correctly, it prevents stomach contents from entering the respiratory tract, and allows asynchronous CPR to be conducted during sudden cardiac arrest. An important element of correct intubation is proper inflation of the endotracheal tube cuff. Research has shown that when medical personnel use the palpation technique, the cuff is usually inflated incorrectly. This can result in numerous health complications for the patient. Methods This research was conducted in 2020 on a group of paramedics participating in the 15th International Winter Championship of Medical Rescuers in Bielsko-Biała. The aim of the research was to assess two methods of inflating the endotracheal tube cuff. Method A involved inflating the cuff using a syringe and assessing the pressure in the control cuff using the palpation technique. Method B involved inflating the cuff using a manometer. During the inflation, both the cuff inflation pressure and the time required to complete the procedure were recorded. Analysis was also conducted on whether completion of certified ALS and ACLS training had any influence on the effectiveness of the inflation procedure. Results The research showed that paramedics using method B significantly more often inflated the endotracheal tube cuff to the correct pressure than those using method A. However, when method B was used, the procedure took longer to conduct. The study also showed that completion of certified ALS or ACLS training did not have a significant influence on proper inflation of the cuff. Those who had completed certified training courses took significantly longer to inflate the endotracheal tube cuff when using method A. Conclusions Inflation of the endotracheal tube cuff by use of a syringe, followed by the palpation technique for assessing the inflation of the cuff balloon is ineffective. Paramedic teams should be equipped with manometers to be used for inflating the endotracheal tube cuff.

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“…Dans la majorité des sé ries publié es, le sexe fé minin, la taille infé rieure à 160 cm et l'âge supé rieur à 50 ans apparaissent comme é tant des facteurs favorisant de rupture traché ale post-intubation [4][5][6][7]. La fragilité de la pars membranosa traché ale dans cette population pourrait en être le support anatomique [8].…”

Section: Discussionunclassified