Abstract
Although the incidence of cuff induced tracheal damage has been considerably reduced by judicious use of tracheal tubes with large-volume, low-pressure cuffs, aspiration continues to be a major problem. A study was conducted to determine the maximum hydrostatic pressure that can be produced by a column of liquid above the tracheal cuff. The vertical and horizontal distance between the upper central incisor teeth and suprasternal notch was measured in 200 supine adult subjects. The maximum vertical and horizontal distance between the upper central incisor teeth and suprasternal notch was 9 cm and 21 cm respectively. The implication of these findings are discussed and it is suggested that a fixed intracuff pressure in the range of 2.5 to 3kPa should be used to obtain an optimal tracheal seal.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bernhard W. N., Cottrell J. E., Sivakumaran C., Patel K., Yost L., Turndorf H. Adjustment of intracuff pressure to prevent aspiration. Anesthesiology. 1979 Apr;50(4):363–366. doi: 10.1097/00000542-197904000-00018. [DOI] [PubMed] [Google Scholar]
- Lomholt N., Borgeskov S., Kirkby B. A new tracheostomy tube. III. Bronchofiberoptic examination of the trachea after prolonged intubation with the NL tracheostomy tube. Acta Anaesthesiol Scand. 1981 Oct;25(5):407–411. doi: 10.1111/j.1399-6576.1981.tb01675.x. [DOI] [PubMed] [Google Scholar]
- Mehta S. M. Performance of low-pressure cuffs. An experimental evaluation. Ann R Coll Surg Engl. 1982 Jan;64(1):54–56. [PMC free article] [PubMed] [Google Scholar]
- Pavlin E. G., VanNimwegan D., Hornbein T. F. Failure of a high-compliance low-pressure cuff to prevent aspiration. Anesthesiology. 1975 Feb;42(2):216–219. doi: 10.1097/00000542-197502000-00019. [DOI] [PubMed] [Google Scholar]
- Turndorf H., Rodis I. D., Clark T. S. "Silent" regurgitation during general anesthesia. Anesth Analg. 1974 Sep-Oct;53(5):700–703. [PubMed] [Google Scholar]