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Clinical evaluation of stethoscope‐guided inflation of tracheal tube cuffs
Author(s) -
Kumar R. D. C.,
Hirsch N. P.
Publication year - 2011
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2011.06853.x
Subject(s) - medicine , cuff , stethoscope , tracheal tube , leak , surgery , anesthesia , thyroid cartilage , seal (emblem) , airway , radiology , larynx , environmental engineering , engineering , art , visual arts
Summary Tracheal tube cuffs are commonly inflated to pressures exceeding the recommended upper limit of 30 cmH 2 O. We evaluated whether a stethoscope‐guided method of cuff inflation results in pressures within the recommended range. Patients were randomly assigned to receive one of two methods of cuff inflation. In the standard ‘just seal’ group, air was introduced into the tracheal cuff until the audible leak at the mouth disappeared. In the stethoscope‐guided group, air was introduced into the cuff until a change from harsh to soft breath sounds occurred, whilst listening with a stethoscope bell placed over the thyroid cartilage. Twenty‐five patients were recruited to each group. The median (IQR [range]) cuff pressure in the ‘just seal’ group was 34 (28–40 [18–49]) cmH 2 O, and in the stethoscope‐guided group was 20 (20–26 [16–28]) cmH 2 O, p < 0.0001. The stethoscope‐guided method of tracheal tube cuff inflation is a novel, simple technique that reliably results in acceptable tracheal cuff pressures.