Adjustment of Intracuff Pressure to Prevent Aspiration

Bernhard, W; Cottrell, James E.; Sivakumaran, Chandrasekara; Patel, Katie; Yost, Leon; Turndorf, Herman

doi:10.1097/00000542-197904000-00018

Cited by 100 publications

(54 citation statements)

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“…Concern regarding safety of such tubes has been expressed [3,6]. Suggested improvements include: appropriate size cuff diameter, preventing longitudinal creases [6], large-diameter, thin, highcompliance cuffs [1,5], improved cuff design (contour, material, high residual volume) combined with control of cuff inflation [4] and smaller diameter high-compliance cuffs with no intracuff invaginations [3]. A high-residual volume, high-compliance, thin-walled cuff, forming tiny transverse wrinkles obliterating the longitudinal slits, might seal off the longitudinal channelling of liquid at an intracuff pressure lower than the mucosal capillary pressure.…”

Section: Discussionmentioning

confidence: 99%

“…The use of tracheal tubes equipped with 'high-volume' cuffs and inflation pressures lower than the intracapillary pressure (< 30 mmHg/< 40 cmH 2 O) has been proposed to prevent mucosal damage resulting from the pressure exerted by the tube cuff [1,2]. However, narrow longitudinal folds form on the surface of a high-volume cuff, as well as between the cuff and tracheal wall, permitting leakage past the cuff [3,4].…”

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confidence: 99%

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Leakage of fluid around low‐pressure tracheal tube cuffs

Oikkonen

Aromaa

1997

Anaesthesia

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SummaryThe aim of the study was to evaluate leakage of liquid past the low-pressure cuffs of tracheal tubes. Ten samples of each of nine different types of tubes were tested in a PVC mock trachea, using intracuff pressures of 20, 30, 40 and 50 cmH 2 O. In five types of tubes, 6-10 cuffs allowed profuse leakage (> 20 ml water in 5 min) even at the highest intracuff pressure, i.e. 50 cmH 2 O. In the most efficient tube, all the cuffs were leak-proof (leakage < 5 ml in 5 min) at 40 cmH 2 O and in the second best type the cuffs were leak-proof at 50 cmH 2 O. The leakage of fluid past the tracheal tube remains an unresolved problem with low-pressure cuffs.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Leakage of fluid around low‐pressure tracheal tube cuffs

Oikkonen

Aromaa

1997

Anaesthesia

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“…Although silent aspiration around cuffed endotracheal tubes (ETT) has been well documented, 17,18 awake intubation or a rapid sequence induction with a cuffed ETT remains the gold standard for patients at risk of aspiration requiring a general anesthetic. A gastric tube may be used to decrease the volume of gastric contents but does not guarantee complete emptying of the stomach and may interfere with gastroesophageal sphincter integrity.…”

Section: Objectifmentioning

confidence: 99%

Protection from aspiration with the LMA-ProSeal™ after vomiting: a case report

Mark

2003

Can J Anesth/J Can Anesth

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“…16 The cuff pressure of an endotracheal tube varies according to patient-related factors, environmental circumstances, and therapeutic interventions. Factors leading to increased cuff pressure include positivepressure ventilation, 17,18 ventilation with nitrous oxide, 19 altitude (eg, during helicopter transport), 20 and pathologic processes such as bronchospasms. 13 Factors that may decrease cuff pressure include sedation and neuromuscular blockade, 21 decreased core temperature, 22 and loss of intracuff volume over patients in the ICU.…”

Section: Caring For Heart Patientsmentioning

confidence: 99%

Recent Advances in Multidisciplinary Critical Care

Blot

Afonso

Labeau

2015

American Journal of Critical Care

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The intensive care unit is a work environment where superior dedication is crucial for optimizing patients' outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. However, given the numerous research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovation in the field. This article broadly summarizes new developments in multidisciplinary intensive care. It provides elementary information about advanced insights in the field via brief descriptions of selected articles grouped by specific topics. Issues considered include care for heart patients, mechanical ventilation, delirium, nutrition, pressure ulcers, early mobility, infection prevention, transplantation and organ donation, care for caregivers, and family matters.

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Adjustment of Intracuff Pressure to Prevent Aspiration

Cited by 100 publications

References 0 publications

Leakage of fluid around low‐pressure tracheal tube cuffs

Leakage of fluid around low‐pressure tracheal tube cuffs

Protection from aspiration with the LMA-ProSeal™ after vomiting: a case report

Recent Advances in Multidisciplinary Critical Care

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