Document Detail


Automated cuff pressure modulation: a novel device to reduce endotracheal tube injury.
MedLine Citation:
PMID:  21242543     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To assess whether dynamically modulating endotracheal tube (ETT) cuff pressure, by decreasing it during each ventilatory cycle instead of maintaining a constant level, would reduce the extent of intubation-related laryngotracheal injury.
DESIGN: Single-blind, randomized controlled animal study using a previously validated live porcine model of accelerated intubation-related tracheal injury.
SETTING: Animal research facility.
PATIENTS: Ten piglets (weight, 16-20 kg each) were anesthetized and underwent intubation using a cuffed ETT.
INTERVENTIONS: The animals were randomized into the following 2 groups: 5 pigs had a novel device to modulate their cuff pressure from 25 cm H(2)O during inspiration to 7 cm H(2)O during expiration, and 5 pigs had a constant cuff pressure of 25 cm H(2)O. Both groups underwent ventilation under hypoxic conditions for 4 hours.
MAIN OUTCOME MEASURE: Laryngotracheal mucosal injury after blinded histopathological assessment.
RESULTS: The modulated-pressure group showed significantly less overall laryngotracheal damage than the constant-pressure group (mean grades, 1.2 vs 2.1; P < .001). Subglottic damage and tracheal damage were significantly less severe in the modulated-pressure group (mean grades, 1.0 vs 2.2; P < .001, and 1.9 vs 3.2; P < .001, respectively). There was no significant difference in glottic or supraglottic damage between the groups (P = .06 and .27, respectively).
CONCLUSIONS: This novel device reduces the risk of subglottic and tracheal injury by modulating ETT cuff pressure in synchronization with the ventilatory cycle. This finding could have far-reaching implications for reducing the risk of airway injury in patients undergoing long-term intubation. Further clinical study of this device is warranted.
Authors:
Neil K Chadha; Arie Gordin; Igor Luginbuehl; Greg Patterson; Paolo Campisi; Glenn Taylor; Vito Forte
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  137     ISSN:  1538-361X     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  30-4     Citation Subset:  AIM; IM    
Affiliation:
MBChB(Hons), BSc(Hons), Division of Pediatric Otolaryngology, BC Children's Hospital, 4480 Oak St, Vancouver, BC V6H 3N1, Canada. nchadha@cw.bc.ca.
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