Changes in endotracheal tube intracuff pressure and air leak pressure over time in anesthetized Beagle dogs. (November 2018)

• Record Type: Journal Article
• Authors: Shin, Chi Won; Son, Won-gyun; Jang, Min; Kim, Hyunseok; Han, Hyungjoo; Cha, Jeesoo; Lee, Inhyung
• Is Part Of: Veterinary anaesthesia and analgesia. Volume 45:Number 6(2018)
• Page Start: 737
• Page End: 744
• Publication Date: 2018-11
• Subjects: air leak pressure -- dog -- endotracheal tube -- intracuff pressure -- time; Veterinary anesthesia -- Periodicals; 636.089
• DOI: 10.1016/j.vaa.2018.06.005
• Languages: English
• ISSNs: 1467-2987

Abstract

Abstract: Objective: To evaluate endotracheal tube intracuff pressure (Pcuff ) changes over time and the effect of these changes on air leak pressure (Pleak ). Study design: Prospective experimental study. Animals: A group of nine healthy adult Beagle dogs. Methods: In part I, in vitro measurements of Pcuff were recorded for 1 hour in eight endotracheal tubes subjected to four treatments: room temperature without lubricant (RT0L), room temperature with lubricant (RTWL), body temperature without lubricant (BT0L), and body temperature with lubricant (BTWL). In part II, nine dogs were endotracheally intubated and Pleak was evaluated at Pcuff of 25 mmHg. Subsequently, Pcuff was reset to 25 mmHg (baseline) and Pcuff measurements were recorded every 5 minutes for 1 hour. Subsequently, a second Pleak measurement was recorded at the current Pcuff . The data were analyzed using Wilcoxon signed-rank test, repeated measuresanova and Mann–Whitney U test. Results: In part I, Pcuff differed significantly between the RT0L and RTWL treatments at 5–60 minutes, and between the BT0L and BTWL treatments at 5–35, 55 and 60 minutes ( p < 0.05). In part II, compared with baseline pressures, mean Pcuff decreased to <18 mmHg at 10 minutes and significant decreases were recorded at 15–60 minutes (Pcuff range: 10.0 ± 4.9 to 13.4 ± 6.3 mmHg, mean ± standard deviation). Significant differences were observed between the first and second Pleak measurements ( p = 0.034). Pleak decreased in six of nine dogs, was not changed in two dogs and increased in one dog. Conclusions and clinical relevance: Significant decreases in Pcuff over time were measured. Pleak may decrease during anesthesia and increase the risk for silent pulmonary aspiration. The results indicate the need for testing Pcuff more than once, especially at 10 minutes after the onset of anesthesia.