The tracheal tube with a high-volume, low-pressure cuff at various airway inflation pressures

Citation
T. Inada et al., The tracheal tube with a high-volume, low-pressure cuff at various airway inflation pressures, EUR J ANAES, 15(6), 1998, pp. 629-632
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
EUROPEAN JOURNAL OF ANAESTHESIOLOGY
ISSN journal
0265-0215 → ACNP
Volume
15
Issue
6
Year of publication
1998
Pages
629 - 632
Database
ISI
SICI code
0265-0215(199811)15:6<629:TTTWAH>2.0.ZU;2-X
Abstract
When the tracheal tube with a high-volume, low-pressure cuff is used, the p ressure exerted by the cuff on the tracheal wall is similar to the intracuf f pressure, and the pressure is claimed to be lower than the capillary perf usion pressure; however, it is not known if this is the case when a high ai rway pressure is required. In a randomized, cross-over design, we studied 6 1 patients (31 men) and measured the intracuff pressures of the tracheal tu be at various airway pressures. While the lungs were inflated at five diffe rent airway pressures in turn (10, 15, 20, 25 and 30 cm H2O), the cuff of t he tracheal tube was inflated with air until it prevented an airleak ('just -seal' pressure). Intracuff pressures [median (range)] at airway pressures of 10, 15, 20, 25 and 30 cm H2O were 8 (0-20), 15 (4-20), 22 (6-32), 26(11- 52) and 31 (16-54) cm H2O, respectively, for men and 6 (0-20), 11 (0-20), 1 5(0-24), 21 (0-32) and 25 (1-41)cm H2O, respectively, for women. Therefore, we conclude that the pressure exerted by the cuff of the tracheal tube on the tracheal wall is unlikely to exceed the capillary perfusion pressure (a rbitrarily defined as 25 mmHg or 34 cm H2O) when the airway pressure is 25 cm H2O or less, but it may exceed the capillary perfusion pressure when the airway pressure is greater than 25 cm H2O.