Intracuff Pressure of Four Brands of Endotracheal Tube Used in Intubated Patient Undergoing General Anesthesia

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Tippimol Khongkaew
Thida Uakritdathikarn
Orarat Karnjanawanichkul

Abstract

Background : Tracheal intubation is associated with many complications including  overinflation of the endotracheal tube cuff and increase in the endotracheal tube from diffusion of nitrous oxide into the cuff. The purpose of this study was to evaluate intracuff pressure of four brands of endotracheal tube in intubated patient undergoing general anesthesia.

Design : A prospective analysis study

Materials and methods : Two hundred and eight ASA class I -III patients undergoing elective surgery were blinded and equally allocated into four groups (Mallinckrodt-hicontour, Curity, Mallinckrodt-hilo and Rusch). Head and neck surgery, BMI ≥ 35 kg/m2, risk of pulmonary aspiration and previously intubated patients were excluded. After monitoring the patients and the induction of anesthesia, the tracheal was intubated with a routine size tube. The intracuff pressure was measured using a manometer after just seal method which was continued every 30 min’s until the operation had finished. Then if the intracuff pressure was ≥ 30 cmH2O, the observer relieved the pressure in the cuff and recorded the volume of air. At the end of the operation the deflated volume was recorded followed by extubation.

Results : The average intracuff pressure of the four brands of endotracheal tube at any one time was < 30 cmH2O and were not statistically significant. There were, however significant differences in the proportion of the intracuff pressure of the four endotracheal tube brands of ≥ 30 cmH2O. (Mallinckrodt-hicontour, Curity, Mallinckrodt-hilo, Rusch: at 30 min, 17.3 %, 17.3 %, 1.9 %, 9.6 %; at 60min, 21.6 %, 35.3 %, 8.0 %, 6.1 %, recpectively.)

Conclusions : The intracuff pressure of Mallinckrodt: hilo and Rusch brands were less than the threshold to produce tracheal pressure necrosis. Therefore, the two brands of endotracheal tube can be use safely during general anesthesia with intracuff pressure monitoring.

Keywords : intracuff pressure, endotracheal tube

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