Effectiveness of the endotracheal tube cuff on the trachea: physical and mechanical aspects

Revista Brasileira de Cirurgia Cardiovascular

Maira Soliani Del Negro¹  Gilson Barreto¹  Raíssa Quaiatti Antonelli¹  Tiago Antônio Baldasso¹  Luciana Rodrigues De Meirelles¹  Marcos Mello Moreira¹  Alfio José Tincani¹ 

关键词: Thoracic Duct;    Thoracic Wall;    Tracheal Stenosis;    Respiratory Aspiration of Gastric Contents;    Suction;    Tubos Torácicos;    Parede Torácica;    Estenose Traqueal;    Aspiração Respiratória de Conteúdos Gástricos;    Sucção;   

DOI  :  10.5935/1678-9741.20140096

来源: SciELO

【 摘 要 】

Introduction: The inflation pressure of the endotracheal tube cuff can cause ischemia of the tracheal mucosa at high pressures; thus, it can cause important tracheal morbidity and tracheal microaspiration of the oropharyngeal secretion, or it can even cause pneumonia associated with mechanical ventilation if the pressure of the cuff is insufficient. Objective: In order to investigate the effectiveness of the RUSCH® 7.5 mm endotracheal tube cuff, this study was designed to investigate the physical and mechanical aspects of the cuff in contact with the trachea. Methods: For this end, we developed an in vitro experimental model to assess the flow of dye (methylene blue) by the inflated cuff on the wall of the artificial material. We also designed an in vivo study with 12 Large White pigs under endotracheal intubation. We instilled the same dye in the oral cavity of the animals, and we analyzed the presence or not of leakage in the trachea after the region of the cuff after their deaths (animal sacrifice). All cuffs were inflated at the pressure of 30 cmH2O. Results: We observed the passage of fluids through the cuff in all in vitro and in vivo experimental models. Conclusion: We conclude that, as well as several other cuff models in the literature, the RUSCH® 7.5 mm tube cuffs are also not able to completely seal the trachea and thus prevent aspiration of oropharyngeal secretions. Other prevention measures should be taken.

【 授权许可】

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