Does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage?: a prospective, randomized, crossover clinical study
Background Methods of determining proper endotracheal tube (ETT) cuff pressure to prevent air leakage include the minimal occlusive volume (MOV) technique, which uses auscultation, and the spirometer technique, which directly measures inspiratory and expiratory breathing volumes. Spirometers may mea...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2020-07-01
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| Series: | Anesthesia and Pain Medicine |
| Subjects: | |
| Online Access: | http://www.anesth-pain-med.org/upload/pdf/apm-20020.pdf |
| _version_ | 1797825497704431616 |
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| author | Ha Yeon Park Mina Kim Junyong In |
| author_facet | Ha Yeon Park Mina Kim Junyong In |
| author_sort | Ha Yeon Park |
| collection | DOAJ |
| description | Background Methods of determining proper endotracheal tube (ETT) cuff pressure to prevent air leakage include the minimal occlusive volume (MOV) technique, which uses auscultation, and the spirometer technique, which directly measures inspiratory and expiratory breathing volumes. Spirometers may measure even small air leakage, therefore, the spirometer technique requires a higher cuff pressure than the MOV technique to completely seal the airway. This study aimed to evaluate the difference in cuff pressure between the two techniques used to seal the airway. Methods Thirty-five female patients were intubated using an ETT with a cuff, and cuff inflation was performed with both techniques at a 10-min interval in random order—the MOV technique and then the spirometer technique or vice versa. The cuff pressure was measured at each period. Results The cuff pressures were 16.7 ± 4.4 cmH2O and 18.7 ± 5.2 cmH2O for the MOV and spirometer techniques, respectively. The cuff pressure for the spirometer technique was 2.0 cmH2O higher than that for the MOV technique and this difference was statistically significant (95% confidence interval, 0.7–3.3; P = 0.003). Considering the upper end (3.3 cmH2O) of the 95% confidence interval and the size of one scale unit (2.0 cmH2O) of a manometer, the difference in cuff pressure was up to 4 cmH2O in practice. Conclusions Even though the air leakage sound disappears on auscultation, unlike the previous recommendation, the airway sealing would be completed only by increasing the cuff pressure by approximately 4 cmH2O. |
| first_indexed | 2024-03-13T10:54:48Z |
| format | Article |
| id | doaj.art-ea3cc33d649f403eb007c232ed8bd584 |
| institution | Directory Open Access Journal |
| issn | 1975-5171 2383-7977 |
| language | English |
| last_indexed | 2024-03-13T10:54:48Z |
| publishDate | 2020-07-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Anesthesia and Pain Medicine |
| spelling | doaj.art-ea3cc33d649f403eb007c232ed8bd5842023-05-17T05:41:38ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772020-07-0115336537010.17085/apm.200201019Does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage?: a prospective, randomized, crossover clinical studyHa Yeon Park0Mina Kim1Junyong In2 Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaBackground Methods of determining proper endotracheal tube (ETT) cuff pressure to prevent air leakage include the minimal occlusive volume (MOV) technique, which uses auscultation, and the spirometer technique, which directly measures inspiratory and expiratory breathing volumes. Spirometers may measure even small air leakage, therefore, the spirometer technique requires a higher cuff pressure than the MOV technique to completely seal the airway. This study aimed to evaluate the difference in cuff pressure between the two techniques used to seal the airway. Methods Thirty-five female patients were intubated using an ETT with a cuff, and cuff inflation was performed with both techniques at a 10-min interval in random order—the MOV technique and then the spirometer technique or vice versa. The cuff pressure was measured at each period. Results The cuff pressures were 16.7 ± 4.4 cmH2O and 18.7 ± 5.2 cmH2O for the MOV and spirometer techniques, respectively. The cuff pressure for the spirometer technique was 2.0 cmH2O higher than that for the MOV technique and this difference was statistically significant (95% confidence interval, 0.7–3.3; P = 0.003). Considering the upper end (3.3 cmH2O) of the 95% confidence interval and the size of one scale unit (2.0 cmH2O) of a manometer, the difference in cuff pressure was up to 4 cmH2O in practice. Conclusions Even though the air leakage sound disappears on auscultation, unlike the previous recommendation, the airway sealing would be completed only by increasing the cuff pressure by approximately 4 cmH2O.http://www.anesth-pain-med.org/upload/pdf/apm-20020.pdfairway managementanesthesiaendotrachealmanometryminimal occlusive volumespirometer |
| spellingShingle | Ha Yeon Park Mina Kim Junyong In Does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage?: a prospective, randomized, crossover clinical study Anesthesia and Pain Medicine airway management anesthesia endotracheal manometry minimal occlusive volume spirometer |
| title | Does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage?: a prospective, randomized, crossover clinical study |
| title_full | Does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage?: a prospective, randomized, crossover clinical study |
| title_fullStr | Does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage?: a prospective, randomized, crossover clinical study |
| title_full_unstemmed | Does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage?: a prospective, randomized, crossover clinical study |
| title_short | Does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage?: a prospective, randomized, crossover clinical study |
| title_sort | does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage a prospective randomized crossover clinical study |
| topic | airway management anesthesia endotracheal manometry minimal occlusive volume spirometer |
| url | http://www.anesth-pain-med.org/upload/pdf/apm-20020.pdf |
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