Effects of Increasing Airway Pressures on the Pressure of the Endotracheal Tube Cuff During Pelvic Laparoscopic Surgery

Rosero, Eric B.; Ozayar, Esra; Eslava-Schmalbach, Javier; Minhajuddin, Abu; Joshi, Girish P.

doi:10.1213/ane.0000000000002657

Cited by 28 publications

(34 citation statements)

References 33 publications

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“…In the study conducted by Rosero EB et al, in patients with BMI≥30 kg/m², who underwent laparoscopic gynecological surgery without using nitrous oxide, the mean cuff pressure, and peak airway pressures were found to be significantly higher in PP period than the period from intubation to insufflation of the abdomen. Besides, the increase in peak airway pressure and cuff pressure was reported to be related to each other, and every 1 cm H 2 O increase in peak airway pressure was found to cause a 0.25 cm H 2 O increase in EI cuff pressure [9]. In our study, we investigated the relationship between pneumoperitoneum periods and peak airway pressures in the TP.…”

Section: Discussionmentioning

confidence: 86%

“…In accordance with the same principle, during positive pressure ventilation, the trachea and the ETT cuff are considered as part of the same closed pneumatic system [9]. In the light of this information, we determined the hypothesis of our study as the insufflation of the cuffs of the EI tubes with saline to prevent the increase of EI cuff pressure in gynecological laparoscopic operations performed in TP and to prevent postoperative sore throat.…”

Section: Discussionmentioning

confidence: 99%

“…Tracheal ulcers are more common in intubated intensive care patients after longterm intubation. Most complications occur due to high ETT cuff pressures, especially ischemia of the mucosa in the anterolateral surface of the trachea [9]. These complications can be prevented by keeping tracheal cuff pressures within the 20- 30 Original Article range, which is regarded as safe.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery

Şahın

Beşir

Akdoğan

et al. 2021

Marmara Medical Journal

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Objective: We compared the air or saline insufflated endotracheal tube (ETT) cuff pressures and their effects on postoperative respiratory complications in gynecological laparoscopic surgeries in the Trendelenburg position (TP). Patients and Methods: This prospective study was carried out on a total of 60 patients, whose ages ranged from 18 to 65 years and who were classified by the American Society of Anesthesiologists (ASA) as I-III. They were scheduled for gynecological laparoscopic surgery in TP. Patients included in the study were randomly divided into two groups as the saline (Group S, n=30) and air (Group A, n=30) groups. ETT cuff pressures and peak airway pressures were recorded immediately after intubation and at 10-minute intervals during the intraoperative period. Results: The cuff pressure and maximum cuff pressure values in the saline group were significantly lower than in the air group in the 50-minute (p<0.05). The sore throat and analgesic consumption were significantly lower in Group S in postoperative 24 hours (p<0.001, for all). Conclusion: The intraoperative cuff pressures, postoperative sore throat, and analgesic consumption were lower in the salineinsufflated group than in the air-insufflated group in gynecological laparoscopic surgery in TP.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery

Şahın

Beşir

Akdoğan

et al. 2021

Marmara Medical Journal

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show abstract

“…The PIP has been reported to be associated with changes in cuff pressure of the ETT in certain conditions. In obese patients with BMI over 30 kg/m 2 who underwent laparoscopic pelvic surgery requiring the Trendelenburg position, i.e., in a model of acute decrease in respiratory compliance, increased airway pressure was associated with the cuff pressure of the ETT [27], which was explained as the elevation in the airway pressure could be transmitted to the ETT cuff. Since most participants of our study were non-obese, it was likely that similar results could not be obtained.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Bronchial Cuff Pressure of Left-Sided Double-Lumen Endotracheal Tube by Lateral Positioning: A Prospective Observational Study

Kim

et al. 2021

JCM

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Proper bronchial cuff pressure (BCP) is important when using a double-lumen endotracheal tube (DLT), especially in thoracic surgery. As positional change during endotracheal tube placement could alter cuff pressure, we aim to evaluate the change in BCP of DLT from the supine to the lateral decubitus position during thoracic surgery. A total of 69 patients aged 18–70 years who underwent elective lung surgery were recruited. BCP was measured at a series of time points in the supine and lateral decubitus positions after confirming the DLT placement. The primary outcome was change in the initial established BCP (BCPi), which is the maximum pressure at which the BCP did not exceed 40 cmH2O without air leak in the supine position, after lateral decubitus positioning. As the primary outcome, the BCPi increased from 25.4 ± 9.0 cmH2O in the supine position to 29.1 ± 12.2 cmH2O in the lateral decubitus position (p < 0.001). Out of the 69 participants, 43 and 26 patients underwent surgery in the left-lateral decubitus position (LLD group) and the right-lateral decubitus position (RLD group) respectively. In the LLD group, the BCPi increased significantly (p < 0.001) after lateral positioning and the beginning of surgery and the difference value, ∆BCPi, from supine to lateral position was significantly higher in the LLD group than in the RLD group (p = 0.034). Positional change from supine to lateral decubitus could increase the BCPi of DLT and the increase was significantly greater in LLD that in RLD.

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“…The recommended ETT cuff pressure to prevent ischemia of tracheal mucosa while reducing the risk of aspiration is 20–30 cm H 2 O. [ 6 ] However, the cuff pressure by manual palpation is usually underestimated, even by experienced emergency physicians. [ 3 7 ] Therefore, to avoid postintubation tracheal rupture during CPR, it would be better to measure the ETT cuff pressure with a manometer immediately after auscultation for tube position confirmation.…”

Section: Discussionmentioning

confidence: 99%

Tracheal rupture related to endotracheal intubation during cardiopulmonary resuscitation

Jung

Durey

Han

et al. 2019

J Emerg Trauma Shock

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Effects of Increasing Airway Pressures on the Pressure of the Endotracheal Tube Cuff During Pelvic Laparoscopic Surgery

Cited by 28 publications

References 33 publications

Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery

Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery

Changes in the Bronchial Cuff Pressure of Left-Sided Double-Lumen Endotracheal Tube by Lateral Positioning: A Prospective Observational Study

Tracheal rupture related to endotracheal intubation during cardiopulmonary resuscitation

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