Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2022; 10(31): 11419-11426
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11419
Pressure changes in tapered and cylindrical shaped cuff after extension of head and neck: A randomized controlled trial
Gukjin Seol, Juhwa Jin, Jinyoung Oh, Sung-Hye Byun, Younghoon Jeon
Gukjin Seol, Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu 41944, South Korea
Juhwa Jin, Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital, Daegu 41944, South Korea
Jinyoung Oh, Sung-Hye Byun, Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
Younghoon Jeon, Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu 41944, South Korea
Author contributions: Seol G drafted the manuscript; Jin J performed the research; Oh J was involved with data collection and assisted with data analysis; Byun SH was involved with data collection and assisted data analysis; Jeon Y participated in study design and assisted with data analysis; all authors read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Kyungpook National University Hospital.
Clinical trial registration statement: This study was registered at the ClinicalTrials.GOV (NCT04503031).
Informed consent statement: All patients provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Younghoon Jeon, MD, PhD, Full Professor, Professor, Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea. jeon68@gmail.com
Received: May 20, 2022
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
Abstract
BACKGROUND

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.

AIM

To investigate cuff pressure between tapered and cylindrical cuff after extension of head and neck during nasal endotracheal intubation.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Keywords: Cuff pressure, Cylindrical cuff, Endotracheal tube, Nasal intubation, Tapered cuff

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.