Abstract
Purpose
Gas leakage around the cuff of a tracheal tube may frequently occur after tracheal intubation and inflation of the cuff. We assessed if the SmartCuff (Smiths Medical Japan, Tokyo, Japan), an automatic cuff pressure controller, would effectively prevent gas leakage.
Methods
Seventy adult patients were allocated randomly to one of two groups. After induction of general anesthesia and tracheal intubation, in one group (Syringe group), a syringe was used to inflate the cuff, until there was no audible gas leakage, at the airway pressure at 20 cmH2O. In the other group (SmartCuff group), the SmartCuff was used to maintain the cuff pressure to be 20 cmH2O. The mechanical ventilation (tidal volume of 8 ml.kg−1 and 12 breaths per min) was started. The incidence and percentage of gas leakage, and the proportion of adequate seal (defined as gas leakage of < 10%) between the groups were compared.
Results
The incidence of audible gas leakage was significantly higher in the Syringe group (10 of 35 patients (28%)) than in the SmartCuff group (none of 35 patients (0%)) (P = 0.00046, 95%CI for difference: 15–43%), and the proportion of adequate seal was significantly lower in the Syringe group (19 of 35 patients (54%)) than in the Smart cuff group (33 of 35 patients (94%)) (P = 0.0001, 95% CI for difference: 20–58%).
Conclusion
Gas leakage may frequently occur after tracheal intubation, and the use of the SmartCuff can effectively maintain the sealing effect of the cuff.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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KU: This author helped in the study conception and design, proposal writing, data collection and management, as well as writing the initial draft and approving the final version of the manuscript. TA: This author made the study conception and design, proposal writing, data management, analysis and interpretation, as well as drafting and approving the final version of the manuscript. YO: This author helped in the study design, proposal writing, as well as revising and approving the final version of the manuscript.
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HA and TS, YO have no conflict of interest; TA is an Associate Editor-in-Chief of the Journal of Anesthesia.
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Urabe, K., Asai, T. & Okuda, Y. Usefulness of an automatic cuff pressure controller (SmartCuff) in inhibiting gasleakage around the cuff after tracheal intubation: a randomized controlled study. J Anesth 38, 86–91 (2024). https://doi.org/10.1007/s00540-023-03283-4
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DOI: https://doi.org/10.1007/s00540-023-03283-4