Document Detail

Volume-Time Curve: An Alternative for Endotracheal Tube Cuff Management.
MedLine Citation:
PMID:  22710636     Owner:  NLM     Status:  Publisher    
BACKGROUND: Despite numerous studies on endotracheal tube cuff pressure (CP) management, the literature has yet to establish a technique capable of adequately filling the cuff with an appropriate volume of air by while generating low CP in a less subjective way. The purpose of this prospective study was to evaluate and compare the CP levels and air volume required to fill the endotracheal tubes cuff using two different techniques, volume-time curve versus minimal occlusive volume, in the immediate postoperative period after coronary artery bypass grafting (CABG). METHODS: A total of 267 patients were analyzed. After the surgery, the lungs were ventilated using pressure controlled continuous mandatory ventilation, and the same ventilatory parameters were adjusted. Upon arrival in the intensive care unit, the cuff was completely deflated and re-inflated, and at this point the volume of air to fill the cuff was adjusted using one of two randomLy selected techniques: volume-time curve and minimal occlusive volume. We measured the volume of air injected into the cuff, the CP and the expired tidal volume of the mechanical ventilation after the application of each technique. RESULTS: The volume-time curve technique demonstrated a significantly lower CP and a lower volume of air injected into the cuff compared to the minimal occlusive volume technique (p <0.0001). No significant difference was observed in the expired tidal volume between the two techniques (p=0.052). However, when the patients were submitted to the minimal occlusive volume technique, 17% (n=47) experienced air leakage as observed by the volume-time graph. CONCLUSIONS: The volume-time curve technique was associated with a lower CP and a lower volume of air injected into the cuff when compared to the minimal occlusive volume technique in the immediate postoperative period after CABG. Therefore, the volumetime curve may be a more reliable alternative for endotracheal tube cuff management.
Douglas Willian Bolzan; Walter Jose Gomes; Sônia Maria Faresin; Ac de Camargo Carvalho; Aa Vincenzo De Paola; Solange Guizilini
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-15
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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