Evaluation of a technique of nitrogen insufflation to decrease plastic endotracheal tube cuff flammability during carbon dioxide laser surgery

Abstract

Study Objective: To determine whether nitrogen insufflation reduces the laser-induced combustibility of polyvinyl chloride (PVC) endotracheal tube cuffs. Setting: Research laboratory of a metropolitan, university-affiliated medical center. Design and Interventions: A plastic catheter was fastened along the shafts of 10 PVC endotracheal tubes with self-adhesive copper foil tape down to a level just above the cuff. The modified endotracheal tubes were inserted into graduated cylinders and flushed with oxygen. The cuffs were then inflated with air, and a carbon dioxide (CO 2) laser was aimed at them. Five of the modified endotracheal tubes had 10 L/min of nitrogen insuffated via the plastic tube. Measurements and Main Results: The laser ignited only 1 of the cuffs insufflated with nitrogen; however, all 5 of the modified endotracheal tubes that were not insufflated burned ( p < 0.05). Conclusion: Nitrogen insufflation decreases CO 2 laser-induced PVC endotracheal tube cuff combustibility. However, clinical applications of this technique should be undertaken with caution, as the administration of a hypoxic mixture may be possible.