Comparison between Two Endotracheal Tube Cuff Inflation Methods; Just-Seal Vs. Stethoscope-Guided

Borhazowal, Rishiraj; Harde, Minal; Bhadade, Rakesh; Dave, Sona; Aswar, Swapnil Ganeshrao

doi:10.7860/jcdr/2017/26301.10017

Cited by 7 publications

(9 citation statements)

References 8 publications

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“…MOV also tends to lead to overinflation in dogs and people. 15,40 However, underinflation has also been reported in humans and in inexperienced operators with the FAS, as previously mentioned. 25,30 The use of a simulator, compared with a live animal, is a limitation of this study, with a possible predisposition to cuff underinflation with P. The simulated trachea in the FAS was a larger ETT.…”

Section: Discussionmentioning

confidence: 73%

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Comparison of four inflation techniques on endotracheal tube cuff pressure using a feline airway simulator

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Makara

Martínez-Taboada

2019

Journal of Feline Medicine and Surgery

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Objectives The aim of this study was to compare four inflation techniques on endotracheal tube cuff (ETC) pressure using a feline airway simulator. Methods Ten participants used four different endotracheal cuff inflation techniques to inflate the cuff of a low-pressure, high-volume endotracheal tube within a feline airway simulator. The simulator replicated an average-sized feline trachea, intubated with a 4.5 mm endotracheal tube, connected to a circle breathing system and pressure-controlled ventilation with oxygen and medical air. Participants inflated the ETC: by pilot balloon palpation (P); by instilling the minimum occlusive volume (MOV) required for loss of airway leaks during mechanical ventilation; until a passive release of pressure with use of a loss-of-resistance syringe (LOR); and with use of a syringe with a digital pressure reader (D) specifically designed for endotracheal cuff inflation. Intracuff pressure was measured by a manometer obscured to participants. The ideal pressure was considered to be between 20 and 30 cmH2O. Data were analysed by Shapiro–Wilk, Kruskal–Wallis and χ2 tests, as appropriate. Results Participants were eight veterinarians and two veterinary nurses with additional training in anaesthesia. Measured median intracuff pressures for P, MOV, LOR and D, respectively, were 25 cmH2O (range 4–74 cmH2O), 41 cmH2O (range 4–70 cmH2O), 31 cmH2O (range 18–64 cmH2O) and 22 cmH2O (range 20–30 cmH2O). D performed significantly better ( P <0.001) than all other techniques, with no difference between the other techniques. Conclusions and relevance Use of D for cuff inflation achieved optimal cuff pressures. There may be high operator-dependent variability in the cuff pressures achieved with the use of P, MOV or LOR inflation techniques. As such, a cuff manometer is recommended when using any of these techniques.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 80%

Comparison of four inflation techniques on endotracheal tube cuff pressure using a feline airway simulator

White

Makara

Martínez-Taboada

2019

Journal of Feline Medicine and Surgery

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“…The ETT cuff performs a critical function of sealing the airway during positive pressure ventilation. Borhazowal et al [18] stated that there is a narrow range of cuff pressure required to maintain a functionally safe seal without exceeding capillary blood pressure. The findings of the current audit do not correlate POST to either ETT size and/or ETT cuff pressure at any of the three facilities.…”

Section: Discussionmentioning

confidence: 99%

Effect of Endotracheal Tube Size and Cuff Pressure on Incidence of Postoperative Sore Throat: Comparison between Three Facilities

Hammad¹

2019

Laparosc Endosc Surg Sci

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It is assumed that lower endotracheal tube (ETT) cuff pressure is associated with a lower incidence of postoperative sore throat. However, this is not confirmed in many studies. The relation between ETT size and cuff pressure and the incidence of postoperative sore throat were studied in three different facilities. Methods: Three facilities at Hamad Medical Corporation, Qatar, Tertiary care hospital/ two secondary care hospitals (2ry (1) and 2ry (2)) were addressed in this study. ETT cuff pressure and size were measured by blinded observer after induction of general anesthesia and patients' intubation before the surgery. The sore throat was recorded after full recovery of the patients and before discharge from PACU by a blinded observer. Statistical analysis was performed using Chi-square for comparing between two categorical variables, Pearson Correlation for parametric variables were used to correlate tube size to cuff pressure. Spearman's for non-parametric variables was used to correlate throat pain to changes in cuff pressure and tube size (Sig. is p<0.05). Results: The sore throat was not significantly correlated to either tube size or cuff pressure in the three facilities. Only at 2ry (1), the tube size was significantly correlated to cuff pressure, probably more standardized work. Conclusion: A large number of trainees at tertiary care hospitals may explain the increased incidence of postoperative sore throat and not ETT size and/or cuff pressure.

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“…However, this would come at a price as the pressure cannot be raised above tracheal capillary blood pressure, approximately 48 cm H2O. 7 Moreover, increasing ETT cuff pressure above 30 cmH2O can compromise blood flow to tracheal mucosa or even stop it at a pressure of 50 cmH20. 8 The commonest causes of post-operative sore throat are high ETT cuff pressure and coughing at the time of emergence.…”

Section: Introductionmentioning

confidence: 99%

Comparison of “Just Seal” vs “Stethoscope Guided” Cuff Inflation Method of Endotracheal Tube Cuff for Reduction of Post Operative Sore Throat

Shah

2022

PAFMJ

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Objective: To compare the efficacy of “Just seal” method of endotracheal tube cuff inflation versus “stethoscope guided”method for reduction of frequency of post operative sore throat. Study Design: Prospective observation study. Place and Duration of study: This study was conducted in Main operation theatre, CMH Kohat from 1st September 2018 to 30th November 2018. Patients and methods: 44 patients divided in two groups of 22 each were made, Group JS and Group SG. Inj Propofol and atracurium was used for induction of general anaesthesia, and Inj Nalbuphine was used as analgesic. Endotracheal intubation with 7.5 internal diameter ETT, was done after 3 minutes of injecting atracurium. In group JS, ETT cuff was inflated gradually till no leakage was heard. In group SG, ETT cuff was inflated slowly and stethoscope bell was placed over thyroid lamina till harsh sounds stopped. Age, volume used to inflate cuff, cuff pressure generated and complain of sore throat 02 hours after extubation were noted. Results: Mean age was 30.22 ±4.7 years and 30.13± 4.2 years for Group JS and SG respectively (p=0.946). Mean volume used was 6.81±0.41 ml and 4.95±0.29 ml for Group JS and SG respectively (p=0.000). Mean pressure generated was 34.90±4.48 cmH2O and 28.91±2.37 cmH2O (p=0.000). Frequency of Post operative sore throat was 54.55% (12/22) in JS group and 18.18 % (4/22) in SG group (p= 0.012). Conclusion: Stethoscope guided technique for inflation of ETT cuff is more effective in reducing frequency of post operative sore throat.

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Comparison between Two Endotracheal Tube Cuff Inflation Methods; Just-Seal Vs. Stethoscope-Guided

Cited by 7 publications

References 8 publications

Comparison of four inflation techniques on endotracheal tube cuff pressure using a feline airway simulator

Comparison of four inflation techniques on endotracheal tube cuff pressure using a feline airway simulator

Effect of Endotracheal Tube Size and Cuff Pressure on Incidence of Postoperative Sore Throat: Comparison between Three Facilities

Comparison of “Just Seal” vs “Stethoscope Guided” Cuff Inflation Method of Endotracheal Tube Cuff for Reduction of Post Operative Sore Throat

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