Presented at the American Society of Pediatric Otolaryngology, Arlington, Virginia. April 25–28, 2013.
Assessment of aspiration risk from dynamic modulation of endotracheal tube cuff pressure
Article first published online: 9 DEC 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 6, pages 1415–1419, June 2014
How to Cite
Kanotra, S. P., Propst, E. J., Luginbuehl, I., Campisi, P., Fisher, J. A. and Forte, V. (2014), Assessment of aspiration risk from dynamic modulation of endotracheal tube cuff pressure. The Laryngoscope, 124: 1415–1419. doi: 10.1002/lary.24481
Drs. Forte and Fisher have registered for a patent for the pressure modulating in-line valve under the auspices of the Commercialization Offices of the Hospital for Sick Children and the University Health Network, respectively. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 27 MAY 2014
- Article first published online: 9 DEC 2013
- Accepted manuscript online: 23 OCT 2013 10:19PM EST
- Manuscript Accepted: 21 OCT 2013
- Manuscript Revised: 28 SEP 2013
- Manuscript Received: 30 MAY 2013
- Mechanical ventilation;
- endotracheal tube;
- modulation of cuff pressure;
- bench top model;
- animal model;
To assess the risk of aspiration using a novel valve circuit that dynamically modulates endotracheal tube cuff pressure during the ventilatory cycle using bench and live animal models.
The bench model consisted of a cuffed endotracheal tube inserted into an artificial trachea. Leakage of liquid around the cuff was measured after 4 hours of constant or dynamic modulation of cuff pressure at variable peak end expiratory pressures. In the porcine model, eight animals were ventilated with the modulating valve circuit and compared to eight controls ventilated with a constant cuff pressure (25 cm of water). Aspiration was monitored quantitatively using a pH probe (measured as voltage) and visually using fluoroscopy.
There was no difference in the amount of fluid leakage around the endotracheal tube cuff in the constant or dynamically modulated pressure-cuff groups in the bench or animal models.
Dynamically modulating endotracheal tube-cuff pressures to minimize tracheal mucosal damage does not increase the tendency to leak around the cuff compared to endotracheal tube cuffs inflated to a constant pressure.
Level of Evidence
N/A. Laryngoscope, 124:1415–1419, 2014