Chest
Volume 68, Issue 6, December 1975, Pages 774-777
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Clinical Investigations
Effect of Cuffed Endotracheal Tubes on Tracheal Mucous Velocity

https://doi.org/10.1378/chest.68.6.774Get rights and content

The inflated cuffed endotracheal tube produces a significant depression of tracheal mucous velocity in anesthetized dogs after one hour. This effect occurs with both low and high compliance cuffs but is not observed with an uncuffed tube. This phenomenon is another factor that must be considered in establishing criteria for the frequency of cuff deflation in patients supported by mechanical ventilators.

Section snippets

Materials

Mongrel dogs weighing 13 to 30 kg (28.7 to 66.1 lb) were anesthetized by intravenous administration of sodium pentobarbital, 30 mg/kg. Pentobarbital in doses of 5 to 10 mg was administered periodically during the experiment to maintain a light level of anesthesia; it was given when skeletal muscular movements occurred. Ventilation was assisted by means of transvenous phrenic nerve stimulation.6 It was necessary to employ this technique in order to maintain adequate gas exchange in the

Uncuffed Endotracheal Tube

There were no significant differences of average tracheal mucous velocity over the four-hour period of breathing air warmed to 38°C with a relative humidity of 100 percent through an uncuffed endotracheal tube compared to the initial value breathing room air through the upper airways (Table 1). The hourly frequency histograms of disk velocities did not differ over the four-hour period.

Low Compliance Cuffed Tube

Inflation of the low-compliance cuff lowered tracheal mucous velocity by 26 percent after one hour (P < 0.02;

DISCUSSION

These experiments have demonstrated that inflation of an endotracheal cuff suppresses tracheal mucous velocity. Passage of an uncuffed tube through the vocal cords kept in situ four hours did not affect this function. The depression in tracheal mucous velocity occurred within one hour, and there was no quantitative difference in this effect between a low- and high-compliance cuff. Further, there was no difference between the two cuffs tested four hours after inflation, although there was a

ACKNOWLEDGMENT

We express our thanks to Dr. Edward Goldberg for supplying the high-compliance cuffed endotracheal tubes.

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    Citation Excerpt :

    Thus, in line with prior findings,15,28,36 the present study showed MCC to be highly depressed. Sackner et al15 suggested the activation of a neurogenic reflex arc upon cuff inflation, but the exact mechanism for this impairment is still unknown. In this context, we found that polyurethane cuffs, in particular the KimVent* MICROCUFF*, caused less tracheal injury and impairment in MCC velocity.

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Supported by National Heart and Lung Institute contract 1-HR-1-2205 and grant HL-17816.

Manuscript received March 26; revision accepted May 5.

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