Abstract
BackgroundLubrication of cuffed tracheal tubes (CTTs) reduces liquid leakage. However, it is not clear how cuff lubrication influences air leakage. We aimed to test the hypothesis that pretreatment with K-Y jelly, a water-soluble lubricant, would improve the air-sealing performance of pediatric CTTs in a model study.MethodsWe placed Parker Flex-Tip™ CTT with 4.0- and 5.0-mm internal diameter (ID) into a tracheal model with 9- and 12-mm ID. The tracheal model was connected to a test lung ventilated in pressure control mode. We compared three cuff lubrication conditions: none (N), water (W), and K-Y jelly (KY). We measured the leak airway pressure (LAWP), defined as the lowest peak airway pressure (PAWP) at which leakage was detected, with the fixed cuff pressure (CP) at 20 cmH2O and varied PAWP. We also measured the leak CP (LCP), defined as the highest CP at which leakage was detected, with fixed PAWP at 25 cmH2O and varied CP. We confirmed air leakage when an apparent elevation of oxygen concentration was detected above the cuff after changing the inspiratory gas from air to oxygen.ResultsFor both 4.0-mm ID and 5.0-mm ID endotracheal tubes, the KY group showed significantly higher LAWP and lower LCP than the other two groups. For the 4.0-mm ID, median values and ranges of LAWP and LCP were K-Y group: 25 (25) and 15 (15); N group: 5 (5) and 35 (35): and W group: 5 (5) and 35 (15–35) cmH2O. For the 5.0-mm ID, median values and ranges of LAWP and LCP were K-Y group: 25 (15–25) and 15 (15–35); N group: 5 (5) and 35 (35); and W group: 5 (5) and 35 (15–35) cmH2O. Water application did not change these outcomes compared with the N group.ConclusionPre-treatment of the cuff with K-Y jelly significantly improved the air-sealing performance of a pediatric CTT in our model study.
Highlights
Lubrication of cuffed tracheal tubes (CTTs) reduces liquid leakage
[1] It is known that lubrication of cuffed tracheal tubes reduces liquid leakage in adult cuffed tubes in a bench-top study and clinical studies. [3,4,5] it is not clear how pretreatment of the cuff with lubricants influences air leakage
We placed Parker Flex-TipTM tracheal tubes of the highvolume low-pressure cuffed type with an internal diameter (ID) of 5.0 mm (Parker tube; Parker Medical, Highlands Ranch, CO, USA, International product number: I-PFHV-50) into a tracheal model consisting of an acrylic cylinder with ID of 12 mm to simulate an approximately 8-year-old patient. [12, 13] We used Parker Flex-TipTM tracheal tubes of the preformed oral cuffed type with ID of 4.0 mm (International product number: I-PFOC-40) and an acrylic tracheal model with ID of 9 mm to simulate an approximately 4-year-old patient
Summary
Lubrication of cuffed tracheal tubes (CTTs) reduces liquid leakage. It is not clear how cuff lubrication influences air leakage. We aimed to test the hypothesis that pretreatment with K-Y jelly, a water-soluble lubricant, would improve the air-sealing performance of pediatric CTTs in a model study. It is well known that the materials and shapes of endotracheal tube cuffs influence their air-sealing properties. [3,4,5] it is not clear how pretreatment of the cuff with lubricants influences air leakage. [11] Using a tracheal model, we aimed to test the hypothesis that pretreatment with K-Y jelly, a water soluble lubricant, would improve the air-sealing performance of pediatric cuffed tracheal tubes Nishioka et al BMC Anesthesiology (2017) 17:129 properties of laminal flow, the leak flow would be correlated with the pressure gradient and inversely correlated with viscosity. [11] Using a tracheal model, we aimed to test the hypothesis that pretreatment with K-Y jelly, a water soluble lubricant, would improve the air-sealing performance of pediatric cuffed tracheal tubes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
