Abstract
Changes in the volume of tracheal tube cuffs were examined during extracorporeal circulation to determine the influence of the composition of the inspired gases and of the gas within the cuff. The study was carried out on 90 patients who underwent coronary artery bypass grafting. When the cuff contains nitrous oxide at the start of extracorporeal circulation, the cuff volume decreases during bypass regardless of the composition of the inspired gases. When the cuff is filled with air or 100 per cent oxygen at the start of extracorporeal circulation and the inspired gas mixture consists of nitrous oxide and oxygen the cuff volume increases. When the cuff is deflated and then refilled with either room air or oxygen at the beginning of the extracorporeal circulation and the lungs are inflated with oxygen, the cuff volume change is minimal during bypass. This combination of gas prevents any undesirable change in the cuff volume. It appears desirable to monitor the tracheal tube cuff volume or pressure and to maintain a constant pressure and volume during bypass to prevent deflation and silent aspiration associated with cuff deflation, as well as to avoid mucosal damage due to excessive pressure in the cuff.
RéSUMé
Les changements de volume du ballonnet des tubes trachéaux ont été étudiés pendant la circulation extracorporelle pour déterminer les effets de la composition des gaz inspirés et des gaz du ballonnet. Cette étude a porté sur 90 patients qui subissaient un pontage aortocoronarien.
Lorsque le ballonnet contenait du protoxyde d’azote au début de la circulation extracorporelle, le volume du ballonnet a diminué pendant le pontage quelque soit la composition de gaz inspiré. Lorsque le ballonnet est vérifié d’air ou d’oxygène, le volume du ballonnet est dégonflé et ensuite empli soit avec de l’air ou de l’oxygène au début de la circulation extracorporelle et que les poumons sont ventilés à l’oxygène, le changement de volume du ballonnet est minime pendant le pontage. Ce mélange de gaz prévient tout changement indesirable du volume du ballonnet. II semble désirable de monitoriser le volume ou la pression du ballonnet du tube trachéal et de maintenir un volume ou une pression constante pendant le pontage pour éviter la déplation et I’aspiration silencieuse associée à la déflation du ballonnet, aussi bien pour éviter d’endommager la muqueuse trachéale par pression excessive par le ballonnet.
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References
Stanley, T.H. Effects of anesthetic gases on endotracheal tube cuff gas volumes. Anesth. & Analg.53: 480(1974).
Stanley, T.H., Kawamura, R. & Graces, C. Effects of nitrous oxide on volume and pressure of endotracheal tube cuffs. Anesthesiology41: 256 (1974).
Stanley, T.H. & Liu, W.S. Tracheostomy and endotracheal tube cuff volume and pressure changes during thoracic operations. Ann. Thorac. Surg.20: 144(1975).
RevenAs, B. & Lindholm, C.E. Pressure and volume changes in tracheal tube cuffs during anaesthesia. Acta Anaesth. Scand.20: 321(1976).
Stanley, T.H. Nitrous oxide and pressures and volumes of high and low pressure endotracheal tube cuffs in intubated patients. Anesthesiology42: 637(1975).
Guyton, A.C. Textbook of Medical Physiology, 5thed. Philadelphia, W.B. Saunders, p. 390(1976).
McIntosh, R., Mushin, W.W. & Epstein, H.G. Physics for the Anaesthetist, 2nd ed. Springfield, CharlesC. Thomas, p. 114(1958).
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Presented at the Association of Cardiac Anesthesiologists in Hollywood, Florida, March 1979.
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Ikeda, S., Schweiss, J.F. Tracheal tube cuff volume changes during extracorporeal circulation. Canad. Anaesth. Soc. J. 27, 453–457 (1980). https://doi.org/10.1007/BF03007043
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DOI: https://doi.org/10.1007/BF03007043