Document Detail


Condensation of humidified air in the inflation line of a polyurethane cuff precludes correct continuous pressure monitoring during mechanical ventilation.
MedLine Citation:
PMID:  24854520     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Within continuously controlled limits of cuff pressure, an endotracheal tube cuff made of polyurethane (PU) prevents secretion inflow better than a conventional polyvinylchloride cuff. However, the temperature difference between ventilator gas and the air inside a PU cuff produces condensation droplets that accumulate in the cuff inflation canal. We investigated whether condensation influenced continuous cuff pressure monitoring. A PU-cuffed tube was placed into an artificial trachea and connected to a ventilator and test lung. An additional line was inserted at the distal cuff end to directly measure pressure inside the cuff. Methylene blue instillation via the inflation line mimicked condensation. Inspiratory (Pinsp) and expiratory (Pexp) pressures were continuously recorded. Six consecutive experiments were performed comparing pressures at baseline (T0) and at 24 h (T24). Shortly after dye instillation, pressures recorded at the inflation canal became permanently fixed at 25 cmH2O. In contrast, pressures measured directly in the cuff progressively decreased (mean Pinsp 30 ± 3 vs. 20 ± 2 cmH2O and mean Pexp 25 ± 0 vs. 12 ± 2 cmH2O, T0 vs. T24, both P < 0.05). Thus, condensation in the inflation line of a PU-cuffed tube renders continuous cuff pressure monitoring unreliable, thereby increasing the risk for microaspiration.
Authors:
Herbert Spapen; Walter Moeyersons; Wim Stiers; Geert Desmet; Emiel Suys
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-23
Journal Detail:
Title:  Journal of anesthesia     Volume:  -     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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