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Báo cáo y học: "Cuff overinflation and endotracheal tube obstruction: case report and experimental study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Cuff overinflation and endotracheal tube obstruction: case report and experimental study | Hofstetter et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 18 http www.sjtrem.eom content 18 1 18 SCANDINAVIAN JOURNAL OF trauma resuscitation emergency medicine ORIGINAL RESEARCH Open Access Cuff overinflation and endotracheal tube obstruction case report and experimental study Christian Hofstetter1 2 Bertram Scheller 1 Sandra Hoegl3 Martin G Mack4 Bernhard Zwissler3 Christian Byhahn1 Abstract Background Initiated by a clinical case of critical endotracheal tube ETT obstruction we aimed to determine factors that potentially contribute to the development of endotracheal tube obstruction by its inflated cuff. Prehospital climate and storage conditions were simulated. Methods Five different disposable ETTs 6.0 7.0 and 8.0 mm inner diameter were exposed to ambient outside temperature for 13 months. In addition every second of these tubes was mechanically stressed by clamping its cuffed end between the covers of a metal emergency case for 10 min. Then all tubes were heated up to normal body temperature placed within the cock of a syringe followed by stepwise inflation of their cuffs to pressures of 3 kPa and 12 kPa respectively. The inner lumen of the ETT was checked with the naked eye for any obstruction caused by the external cuff pressure. Results Neither in tubes that were exposed to ambient temperature range -12 C to 44 C nor in those that were also clamped visible obstruction by inflated cuffs was detected at any of the two cuff pressure levels. Conclusions We could not demonstrate a critical obstruction of an ETT by its inflated cuff neither when the cuff was over-inflated to a pressure of 12 kPa or higher nor in ETTs that had been exposed to unfavorable storage conditions and significant mechanical stress. Introduction and Case Frequent causes for critical obstruction of a cuffed ETT include kinking secretions and cuff hernia 1 2 . This study was initiated by the observation of a case of critical endotracheal tube ETT .