Abstract
Large-volume low-pressure cuffs have been introduced in an endeavour to reduce the incidence of tracheal mucosal damage. These cuffs when inflated to clinical seal develop folds, which together with low clinical seal pressure may not protect against aspiration.
This study compares the incidence of aspiration of dye past a variety of large-volume cuffed tubes and red rubber low-volume cuffs inflated to clinical seal in a group of 30 patients.
The incidence of dye tracking past the large-volume cuffs studies was 100 per cent whereas no aspiration of dye was seen past the red rubber tubes.
Increasing cuff pressure in the large-volume cuffs beyond clinical seal to 50 cm H2O did not obliterate the dye-filled cuff folds, despite wide variation in the thickness of the cuff material.
Résumé
Les ballonnets à basse pression et grand volume ont été introduits afin de diminuer l’incidence des lésions de la muqueuse trachéale. Ces ballonnets quand gonflés afin d’assurer un étanchéité clinique peuvent développer des plicatures qui accompagnées d’une pression d’occlusion basse peuvent ne pas protéger contre l’aspiration.
Cette étude compare l’incidence de l’aspiration de colorant à travers une variété de ballonnets à large volume et les ballonnets à petit volume en caoutchouc rouge gonflés afin d’assurer l’étanchéité clinique dans un groupe de 30 patients.
L’incidence de colorant trouvée au delà des ballonnets à large volume etait de 100 pour cent alors qu’aucune aspiration de colorant n’a été vue au delà des ballonnets à faible volume de tube endotrachéal en caoutchouc rouge.
L’augmentation de la pression dans le ballonnet des tubes endotrachéaux à gros volume jusqu’a 50 cm H2O n’a pas diminué la plicature de ces ballonnets malgré les variations énormes dans l’épaisseur du matériel de ces ballonnets.
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Seegobin, R.D., van Hasselt, G.L. Aspiration beyond endotracheal cuffs. Can Anaesth Soc J 33, 273–279 (1986). https://doi.org/10.1007/BF03010737
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DOI: https://doi.org/10.1007/BF03010737