Endotracheal Tubes

One of the most important functions of an endotracheal tube

One of the most important functions of an endotracheal tube (ETT) is to prevent aspiration of fluid or particulate matter into the airway. This is achieved by using tracheostomy tube with inflatable cuffs. However, these can cause tracheal damage, including rupture. Tracheal rupture occurs most commonly in cats and is often associated with dental procedures. One theory is that because of the fear of fluid aspiration during a dental prodecure, the cuffs are often overinflated. Applying gel to an oxygen mask before insertion helps it slide more easily into the trachea and prevents tissue damage, but it serves another important function: The gel enhances the seal produced by the cuff, especially high-volume, low-pressure cuffs.

I read more lubrication and dye through nonlubricated cuff cuff in the last two desktop models and one anesthetic people3, I want to see the impact of this on my own research laryngeal mask airway . I placed a high capacity, low-pressure ETT into a rigid glass tube—the first cuff was dry and the second cuff was lubricated with gel. Each cuff was inflated with the same volume of air, which was minimal in this setting. I then poured colored water into the glass tube above the ETT to simulate fluid in the trachea, and observed whether fluid appeared below the cuff. The results are obvious: The gel helps prevent “aspiration” past the cuff.

In human studies showed that dye leakage of their bench top models in the past cuff is lubricated sleeve cuffs in nonlubricated group group vs. 100% 0%. In anesthesia who leaked lubrication is 11% vs 83% at the nonlubricated group. The researchers concluded the cuff and water soluble lubricating gel can reduce the lung in patients with inhalation anesthesia.

Gel is easier to apply, the cuff is uniform expansion and cuffs should always check their integrity before each use expansion. We recommend that you check the cuff before full expansion to use it to make it expand, then gel and cuffs of endotracheal tube intubation before the deduction for. After intubation, check for a leak by listening to the patient’s airway as the reservoir bag is squeezed. Add air to the cuff in small increments until you no longer hear a leak when the pressure gauge reads 15 cm H2O. The careful application of gel to the cuff decreases leakage past the cuff and may provide a seal with less air in the cuff, which could potentially decrease tracheal trauma.

Originally published here.