RT Journal Article
SR Electronic
T1 Bench Study of a New Device to Display and Maintain Stable Artificial Airway Cuff Pressure
JF Respiratory Care
FD American Association for Respiratory Care
SP 1506
OP 1513
DO 10.4187/respcare.00961
VO 56
IS 10
A1 Howard, William R
YR 2011
UL http://rc.rcjournal.com/content/56/10/1506.abstract
AB BACKGROUND: Artificial airway cuff pressure should be maintained within a narrow range. Excessive cuff pressure presents a risk of tracheal damage and stenosis. Insufficient cuff pressure adds the risk of secretion leak past the cuff, tidal-volume leakage, and accidental extubation. The available cuff-inflation devices do not address these problems. OBJECTIVE: In the laboratory I developed and evaluated a new cuff-inflation device that continuously displays the cuff pressure and maintains stable cuff pressure. METHODS: The cuff-inflation device evaluation included: test the manometer accuracy; compare the displayed pressure to the pressure delivered to the pilot balloon; determine the device's response to cuff-pressure changes with the addition of 5 mL or 10 mL of air after achieving a 30 cm H2O baseline; measure the VT leak in an intubated artificial trachea by comparing the device results to benchmark measurements; and determine the stability of baseline cuff pressure during routine cuff checks. RESULTS: The mean ± SD bias and precision of device's display, compared to the calibration analyzer, was 1.3 ± 2.6 cm H2O. The pressure delivered by the cuff-inflation device's gas-sampling line to the pilot balloon was equal to the pressure displayed by the cuff-inflation device. With the cuff-inflation device the cuff pressure was unchanged, compared to baseline, after adding 5 mL or 10 mL of air. With 2 current cuff methods, cuff pressure increased to means exceeding 160 cm H2O and 300 cm H2O, respectively. Compared to the benchmark, the difference in exhaled VT mean ± SD bias and precision were: cuff-inflation device 1.4 ± 4.8 mL, and syringe-inflation method 2.4 ± 6.2 mL. Representing a single cuff pressure check, disconnecting the endotracheal-tube pilot balloon from the cuff-inflation device's gas-sampling line and then reconnecting it had no effect on baseline cuff pressure at 2 seconds or 60 seconds. CONCLUSIONS: The cuff-inflation device demonstrated possible improvements over available cuff-inflation devices and cuff-pressure-control methods.