Most patients who admitted in our intensive care units and need prolong mechanical ventilation, have a conventional endotracheal tube, in this context we thought about a new solution: "elective replacement of conventional endotracheal tube using endotracheal tube with subglottic suction port, in intensive care unit", early after decision to mechanical ventilation for at least 48 hours, an idea that had beneficial effects in the study of Doyle et al (8); In that study, endotracheal tube replacement fallowed by using PneuX system (Venner Medical, Singapore), a certain tube with cuff pressure
monitoring, warrant sealing, to reduce the aspiration of the secretions, together with intermittent suction of subglottic secretions; their study showed significant reduction in VAP incidence.
However, in our study, the PLMA cuff pressure
decreased to 40 cm [H.
This may be due to TT cuff pressures
exceeding tracheal mucosal perfusion pressure or due to abrasion of the tracheal wall from movement of the tip of the TT during ventilatory movements, tracheal suctioning and excessive neck movements.
With all endotracheal tubes, measuring tube cuff pressure
is also an important measure in regard to reduction of VAE.
We also used contrasts to determine if there was a difference in heart rate or blood pressure at the baseline cuff pressure
to those of the other cuff pressures
In line with our results, their results showed that the cuff pressure
of 60 cmH[sub]2O exerted higher OLP than 40 cmH[sub]2O cuff pressure
and was comparable to 80 cmH[sub]2O in pediatric patients.
Lower Tourniquet Cuff Pressure
Reduces Postoperative Wound Complications After Total Knee Atrhroplasty.
is particularly risky when exerted posteriorly against a rigid nasogastric tube in the oesophagus.
Conclusion: If careful measures regarding insertion techniques, correct LMA position and routine monitoring of LMA cuff pressure
are taken, LMA can be used as a safe alternative with lower incidence of post operation complication compared with ETT during low-flow controlled anesthesia with modern anesthetic machines.
Important intubation considerations for the anesthesiologist taking care of a singer include size of the tube, good view of the vocal folds (which should be relaxed) during tube placement, minimum attempts at intubation (preferably at first attempt), keeping the cuff pressure
to minimum, preventing movement of the tube during surgery and during emergence from anesthesia, and prevention of aspiration in the perioperative period.
Although we can argue that measured cuff pressure
represents a gold standard, its accuracy will still depend on the accuracy of the device and the technique to use the device including the error rate and calibration of the device and equilibrium time needed to optimise the accuracy of the device.
This review describes the pathophysiology associated with inflated ET tube cuffs and the complications associated with excessive cuff pressure
on the tracheal mucosa.