Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11419
Peer-review started: May 20, 2022
First decision: August 21, 2022
Revised: August 31, 2022
Accepted: September 29, 2022
Article in press: September 29, 2022
Published online: November 6, 2022
The proper cuff pressure of endotracheal tube (ET) plays an important role in sealing the airway and preventing airway complications during mechanical ventilation. The ET cuff shape affects the cuff pressure after positional change.
To investigate cuff pressure between tapered and cylindrical cuff after extension of head and neck during nasal endotracheal intubation.
In a randomized clinical trial, 52 patients were randomized to one of two groups: cylindrical cuff or Tapered cuff. Cuff pressure with 22 cmH2O was applied to patients in the neutral position. After extension of head and neck, the cuff pressure was evaluated again and readjusted to 22 cmH2O. In addition, the extent of cephalad migration of ET tip was assessed and postoperative airway complications such as sore throat, and hoarseness were measured.
The cuff pressure was higher in the tapered cuff (28.7 ± 1.0 cmH2O) than in the cylindrical cuff (25.5 ± 0.8 cmH2O) after head and neck extension (P < 0.001). The extent of cephalad migration of tube tip was greater in TaperGuard ET (18.4 ± 2.2 mm) than in conventional ET (15.1 ± 1.2 mm) (P < 0.001). The incidence of postoperative airway complications was comparable between two groups.
After head and neck extension, the cuff pressure and the extent of cephalad migration of ET was greater in tapered cuff than in cylindrical cuff during nasal intubation, respectively.
Core Tip: The proper cuff pressure of endotracheal tube is very important in a sealing airway and avoiding airway complication during mechanical ventilation. This was a clinical randomized clinical trial comparing cuff pressure between tapered and cylindrical cuff after head and neck extension during nasal endotracheal intubation. The cuff pressure and the extent of cephalad migration of tube tip was greater in TaperGuard endotracheal tube than in conventional endotracheal tube after head and neck extension, respectively.