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Clinical Study on an Endotracheal Tube with a High‐Residual Volume, Low‐Pressure Cuff
Author(s) -
Saarnivaara L.,
Grahne B.
Publication year - 1981
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1981.tb01614.x
Subject(s) - medicine , anesthesia , nitrous oxide , cuff , sore throat , surgery
The development of intracuff pressure in a Shiley tube with a high‐residual‐volume, low‐pressure cuff was studied in 61 patients during nitrous oxide‐oxygen anaesthesia and after replacement of nitrous oxide with nitrogen in the anaesthesia system. The mean minimal occluding pressure of the cuff filled with air was 18 cmH 2 O (1.8 kPa). In the 27 Group I patients, the intracuff pressure was always adjusted to its initial value after reaching the value of 25 cmH 2 O (2.5 kPa). In the 34 Group II patients, the intracuff pressure was allowed to increase freely. In Group I, the intracuff pressure reached the value of 25 cmH 2 O (2.5 kPa) in about 34 min. In Group II, the intracuff pressure increased linearly up to 120 min, reaching the value of 38 cmH 2 O (3.7 kPa). Thereafter, the increase in the intracuff pressure slowed to about 40 cmH 2 O (3.9 kPa) at 150 min. During 60 min after the replacement of nitrous oxide with nitrogen, the intracuff pressure in Group I decreased from 22 cmH 2 O (2.2 kPa) to 15 cmH 2 O (1.5 kPa) and in Group II from 36 cmH 2 O (3.5 kPa) to 24cmH 2 O(2.4kPa). During 240 min after extubation, the incidence of hoarseness ranged from 12 to 25% in Group I and from 19 to 28% in Group II. During 60 min after extubation, sore throat did not occur in Group I, whereas in Group II, its incidence was 13% (P < 0.05). No other side‐effects possibly associated with intubation were noticed. Eighty percent of the patients who developed side effects were women, whereas 60% of all patients were women. The present results suggest that even during a relatively short period of intubation of 120 to 140 min, the intracuff pressure should be controlled and kept below the value of 25 cmH 2 O (2.5 kPa).