Evaluation of an Artificial Airway Cuff Inflator

Abstract

Background: Setting and maintaining adequate endotracheal tube and tracheostomy tube cuff pressures is an important step in providing safe respiratory care. Airway cuffs, when properly inflated, provide protection against aspiration of fluids into the lungs and help maintain airway pressures while using mechanical ventilation. Conversely, over-inflation of airway cuffs can cause an array of issues, from irritation to injury and necrosis of the tracheal wall. We tested the Vortran Cuff Inflator (Vortran Medical Technology, Sacramento, California), to determine if it accurately set pressures. The null hypothesis is that there will be no difference between the measured pressures and the control.

Methods: We used an airway model (Laerdal Airway Management Trainer, Wappingers Falls, New York) to simulate an intubated patient and intubated it with an 8.0 mm ID endotracheal tube (Covidien, Dublin, Ireland). The cuff was inflated using the Vortran inflator. Using a stopcock, the cuff inflator was used to fill the ETT cuff to meet the pressure of 20, 30, and 40 cm H₂O on the analog manometer. Once the needle on the Vortran Cuff Inflator reached the center of the desired number on the manometer, the stopcock was turned off to the inflator and the pressure was measured via a SmartLab Series 1140 (Hans Rudolph, Shawnee, KS). The process was repeated five times at each pressure on two devices, and data recorded. After each trial, the cuff was deflated and disconnected and the SmartLab sensor was zeroed.

Results: The measured pressure readings at 20, 30, and 40 cm H₂O were different than the control (P < .001). Mean pressure readings at each of the three inflation points were: 25.68 cm H₂O, 34.89 cm H₂O, and 47.48 cm H₂O.

Conclusions: The Vortran Cuff Inflator exhibited statistical differences between control and measured values at 20, 30, and 40 cm H₂O. More research is needed to determine if our findings are clinically significant. With these findings, the null hypothesis is rejected.