Chest
Clinical InvestigationsEffect of Cuffed Endotracheal Tubes on Tracheal Mucous Velocity
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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Supported by National Heart and Lung Institute contract 1-HR-1-2205 and grant HL-17816.
Manuscript received March 26; revision accepted May 5.