An in-vitro study to evaluate high-volume low-pressure endotracheal tube cuff deflation dynamics.

Abstract:

BACKGROUND:High-volume low-pressure (HVLP) endotracheal tube (ETT) cuffs for critically ill patients often deflate during the course of mechanical ventilation. We performed an in-vitro study to comprehensively assess HVLP cuff deflation dynamics and potential preventive measures. METHODS:We evaluated 24-hour deflation of seven HVLP cuffs of cylindrical or tapered shape, and made of polyvinylchloride or polyurethane. Experiments were performed within a thermostated chamber set at 37 °C. In the first stage of experiments, the cuff pilot balloon valve was not manipulated. The cuff internal pressure was assessed hourly for 24 hours, via a linear position sensor which monitored cuff deflation displacements. Then, we re-evaluated cuff deflation of the worst-performing ETT cuffs with the cuff pilot balloon valve sealed. Finally, we inflated ETT cuffs within an artificial trachea to evaluate deflation dynamics during mechanical ventilation. RESULTS:Initial tests showed an exponential decrease in cuff internal pressure in five out of seven cuffs. Cuffs of cylindrical shape and made of polyurethane demonstrated the fastest deflation rates (P<0.050 vs. cuffs of conical shape and made of polyvinylchloride). When the cuff pilot balloon valve was not sealed, the internal cuff pressure deflation rate differed significantly among ETTs (P=0.005). Yet, upon sealing the cuff pilot balloon valve and during mechanical ventilation, cuff deflation rates decreased (P<0.050). CONCLUSIONS:In controlled in-vitro settings, ETT cuffs consistently deflate over time, and the cuff pilot balloon valve plays a central role in this occurrence. Deflation rate decreases when cuffs are inflated within a plastic artificial tracheal model and mechanical ventilation is activated.

journal_name

Minerva Anestesiol

journal_title

Minerva anestesiologica

authors

Marti JD,Li Bassi G,Isetta V,Lazaro MR,Aguilera-Xiol E,Comaru T,Battaglini D,Meli A,Ferrer M,Navajas D,Pelosi P,Chiumello D,Torres A,Farre R

doi

10.23736/S0375-9393.19.13133-1

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

846-853

issue

8

eissn

0375-9393

issn

1827-1596

pii

S0375-9393.19.13133-1

journal_volume

85

pub_type

杂志文章
  • [Methicillin-resistant staphylococci in pediatric resuscitation].

    abstract:OBJECTIVE:To evaluate the incidence of colonization and infection by methicillin-resistant in PICU. DESIGN:Prospective cohort study during 2 years for the surveillance of nosocomial infections. SETTING:Four beds Pediatric Intensive Care Unit. PATIENTS:We studied two-hundred patients with duration of hospitalization ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Pigna A,Pirazzini M,Grillione G,Gatti M,Corticelli AS

    更新日期:1995-06-01 00:00:00

  • [Surgical indications for the treatment of cervico-spinal cord injuries].

    abstract::The surgical treatment of cervico-medullary traumas is indicated, in unstable lesions, in large lesions of the mobile rachidic segment in the presence of neurological complications or following worsening of prior neurological symptomatology. The purpose of the operation is at least three-fold: to obtain alignment of v...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Fasano VA

    更新日期:1989-03-01 00:00:00

  • [Hemodynamic and respiratory aspects in orthotopic liver transplantation].

    abstract::Intraoperative hemodynamic and respiratory data from one-year experience of orthotopic liver transplantation with veno-venous bypass (10 cases) were collected. Seven different phases of OLT was submitted to one way analysis of variance. Variability is due to degree and duration of liver disease. Basal conditions inclu...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Antonini M,Pastore E,Bufi M,Calzecchi E,Guerricchio R,Della Rocca G,Pinelli ML,Gasparetto A

    更新日期:1990-04-01 00:00:00

  • Clinical decision support system clears the way for perioperative goal directed therapy protocol adherence improvement: a reply.

    abstract:: ...

    journal_title:Minerva anestesiologica

    pub_type: 评论,信件

    doi:10.23736/S0375-9393.19.13586-9

    authors: Menger J,Dworschak M

    更新日期:2019-06-01 00:00:00

  • [Intravenous anesthesia with perfused propofol combined with loco-regional spinal anesthesia].

    abstract::The authors review the advantages and disadvantages of general and regional anesthesia in bad clinical conditions. The purpose of this study was to evaluate the efficacy of Blended Anesthesia (association of general anesthesia with a regional technique) in 25 patients belonging to ASA classes II-III-IV, undergoing sur...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Lo Presti C,Vitalone V,Fusco G,Assisi P

    更新日期:1993-04-01 00:00:00

  • [Experience of an intermediate respiratory intensive therapy in the treatment of prolonged weaning from mechanical ventilation].

    abstract::109 patients who suffered from an episode of acute respiratory failure, necessitated mechanical ventilation (MV) in a general Intensive Care Unit (ICU) and admitted to our Respiratory Intermediate Intensive Unit (RIIU), were retrospectively evaluated for outcome and weaning success. The patients, 69 +/- 9 years old, p...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Vitacca M,Clini E,Porta R,Sereni D,Ambrosino N

    更新日期:1996-03-01 00:00:00

  • Preconditioning effects of the anesthetic administered to the donor on grafted kidney function in living donor kidney transplantation recipients.

    abstract:BACKGROUND:In living donor kidney transplantation (LDKT), we evaluated if there was any difference in grafted kidney function according to the type of anesthetic used in the donor because some laboratory studies have demonstrated that volatile anesthetics at clinically relevant concentrations protect the kidneys agains...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Lee JH,Joo DJ,Kim JM,Park JH,Kim YS,Koo BN

    更新日期:2013-05-01 00:00:00

  • [Changes in the parameters of humoral immunity due to surgical operations or trauma].

    abstract::Humoral immunity (immunoglobulins and C3) as well as nutritional conditions (serum albumin, transferrin) have been investigated in 23 patients in the acute phase after surgery and/or trauma. Immunoglobulin deficiency, well correlated with the severity of trauma, was observed in the most critically ill patients in the ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Guarducci AM,Langer M,Solca M,Radrizzani D,Carnevale-Maffè A

    更新日期:1981-08-01 00:00:00

  • [Althesin in general surgery].

    abstract::An account is given of the employment of althesin as an induction and maintenance anaesthetic. It is free of the drawbacks observed with thiopentone induction, and has negligible haemodynamic and respiratory effects. Its association with leptophen permitted excellent analgesia at minimal leptophen doses, without secon...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Liistro A

    更新日期:1980-02-01 00:00:00

  • [Validity of the V/Q index in the monitoring of critical patients].

    abstract::The Authors have controlled the validity of VQI to quantify pulmonary shunt (Qs/Qt). The survey involved (group A) patients who had undergone major surgery and (group B) patients hospitalized in ICU for cardiorespiratory failure. Four subgroups were identified in both the groups according to different values of SaO2. ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Donati A,Orsetti G,Bini G,Luzi A,Valente M,Giovannini C,De Ritis GC,Pietropaoli P

    更新日期:1992-01-01 00:00:00

  • Goal-directed fluid management in free flap surgery for cancer of the head and neck.

    abstract:BACKGROUND:Goal-directed fluid management using stroke volume variation (SVV) analysis is not well studied in free flap reconstruction surgery in patients with head and neck cancer. METHODS:Patients operated due to cancer of the head and neck with free flap reconstruction during 2008-2010 and 2012-2014 in Oulu Univers...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:10.23736/S0375-9393.16.11451-8

    authors: Lahtinen SL,Liisanantti JH,Poukkanen MM,Laurila PA

    更新日期:2017-01-01 00:00:00

  • Metabolic stress during hypoglycaemia clamp assessed by microdialysis.

    abstract:AIM:Microdialysis allows the biochemical analysis of interstitial fluids as a bedside procedure. This technique is of interest to evaluate the glucose dependent metabolism in hypoglycaemic patients. It was the aim to perform subcutaneous and blood microdialysis during hypoglycaemic clamp experiments in 12 healthy young...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Bahlmann L,Oltmanns KM,Peters A,Poeling J,Schwemmer U,Heringlake M,Klaus S

    更新日期:2005-11-01 00:00:00

  • [The use of propofol in a female patient predisposed to malignant hyperthermia (central core disease)].

    abstract::In this paper the Authors describe the anesthetic techniques used for abdominal surgery in a 19 year-old woman with "central-core disease". This uncommon congenital neuromuscular disorder is frequently related to malignant hyperthermia syndrome. Total intravenous anesthesia with the association propofol-fentanyl was w...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Rivolta M,Riedo R,Ostaldo M,Fontana G,Motta F

    更新日期:1992-04-01 00:00:00

  • Non-opioid analgesics for pain management following ambulatory surgery: a review.

    abstract::Multimodal pain management, combining analgesics with different mode of action in order to minimize occurrence of side-effects still providing safe and efficacious pain management after ambulatory surgery has become standard of care. The combined use of local anaesthesia in order to reduce noxious influx during the pr...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Warren-Stomberg M,Brattwall M,Jakobsson JG

    更新日期:2013-09-01 00:00:00

  • Incidence of hypotension and bradycardia during integrated epidural/general anaesthesia. An epidemiologic observational study on 1200 consecutive patients. Italian Study Group on Integrated Anaesthesia.

    abstract:BACKGROUND:Combined epidural/general anaesthesia might theoretically emphasise the cardiovascular effects of epidural block alone. The goal of the present investigation was to evaluate the incidence of both hypotension and bradycardia during integrated epidural/general anaesthesia in a multicentric, observational study...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Fanelli G,Casati A,Berti M,Rossignoli L

    更新日期:1998-07-01 00:00:00

  • Management of massive operative blood loss.

    abstract::Coagulopathy associated with massive operative blood loss is an intricate, multicellular and multifactorial event. Massive bleeding can either be anticipated (during major surgery with high risk of bleeding) or unexpected. Management requires preoperative risk evaluation and preoperative optimization (discontinuation ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Kozek-Langenecker S

    更新日期:2007-07-01 00:00:00

  • Modulation of inflammation during acute normovolemic anemia with different fluid replacement.

    abstract:BACKGROUND:Acute normovolaemic anemia (ANA) frequently occurs during cardiopulmonary bypass (CPB) and major surgeries. We investigated whether fluids (with different compositions) used to replace blood elicit any degree of systemic or lung inflammatory response. METHODS:We evaluated systemic and pulmonary inflammatory...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Kahvegian M,Aya Otsuki D,Holms C,Oliveira Massoco C,Costa Auler Júnior JO,Tabacchi Fantoni D

    更新日期:2013-10-01 00:00:00

  • [Neuroleptic malignant syndrome. Problems of differential diagnosis. Description of a clinical case].

    abstract::Neuroleptic malignant syndrome (NMS) in its most severe form ranging from disorders of consciousness to coma is now reported relatively frequently in intensive care journals. Having observed such a case in the intensive care ward of their hospital, the Authors investigate the possibility of differential diagnosis betw...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Musto P,Vinay P,Coalda M,Bono D,Vai G

    更新日期:1992-07-01 00:00:00

  • Chronic pain: not only a matter of time.

    abstract::The term "chronic" is often used in daily clinical practice to indicate a type of pain that lasts over time and is accompanied by diagnostic and therapeutic difficulties. The common feeling is that in this category are actually collected many different clinical cases with the unique characteristic that the pain lasts ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Bonezzi C,Demartini L,Buonocore M

    更新日期:2012-06-01 00:00:00

  • Surgical management of abdominal compartment syndrome.

    abstract:BACKGROUND:The majority of intensive care physicians recognize the clinical significance of intra-abdominal hypertension on the outcome of critically ill patients. Abdominal compartment syndrome (ACS) is defined as an intra-abdominal pressure (IAP) >20 mmHg with ongoing organ failure. However, there is no consensus reg...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Chiara O,Cimbanassi S,Boati S,Bassi G

    更新日期:2011-04-01 00:00:00

  • Mechanotransduction in the lungs.

    abstract::Mechanical ventilation may induce or aggravate lung injury, a phenomenon known as ventilator induced lung injury (VILI). On a macroscopic level, the effects of mechanical stress and strain on lung tissue are well described. Increased tidal volumes may lead to volutrauma, raised airway pressures may cause barotrauma an...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Spieth PM,Bluth T,Gama De Abreu M,Bacelis A,Goetz AE,Kiefmann R

    更新日期:2014-08-01 00:00:00

  • [Continuous intravenous infusion with patient-controlled anesthesia for postoperative analgesia in cesarean section: morphine versus buprenorphine].

    abstract::A double blind comparison between morphine and buprenorphine was performed in 20 patients using a new demand and continuous infusion analgesic system to provide analgesia after cesarean section. The patients were randomized in two equal groups to receive either morphine 1 mg/h or buprenorphine 0.03 mg/h. The PCA syste...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Capogna G,Celleno D,Sebastiani M,Costantino P,Reggio S

    更新日期:1989-01-01 00:00:00

  • Limiting harm in the ICU.

    abstract::This year, the US Institute of Medicine has estimated that medical errors kill up to 98,000 Americans each year,1 a problem surpassing automobile fatalities. For patients on the medical ward, drug therapy is the primary intervention they are receiving yet medication errors occur in as many as 4% of inpatients.2 Althou...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Subramanian S,Kellum JA

    更新日期:2000-05-01 00:00:00

  • [Enoximone in weaning from mechanical circulation support in pediatric patients].

    abstract:OBJECTIVE:To assess and record the response to continuous infusion of the phosphodiesterase inhibitor enoximone during weaning from mechanical circulatory support (MCS) and to verify the possibility of success with this indication in pediatric patients. DESIGN:Retrospective study. SETTING:Pediatric cardiac surgery in...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章

    doi:

    authors: Bevilacqua S,Del Sarto P,Tommasini G,Moschetti R,Scebba L,Murzi B,Genovesi M,Nicolini A,Santoli F

    更新日期:1997-01-01 00:00:00

  • QT interval and QT dispersion during the induction of anesthesia and tracheal intubation: a comparison of remifentanil and fentanyl.

    abstract:BACKGROUND:The aim of this paper was to determine if there were any significant differences between the effects of fentanyl delivered as a bolus or remifentanil delivered as a continuous infusion on the QT interval and QT dispersion (QTD) during the induction of anesthesia and tracheal intubation. METHODS:This was a p...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Cafiero T,Di Minno RM,Di Iorio C

    更新日期:2011-02-01 00:00:00

  • Anaesthetic management in asthma.

    abstract::Anaesthetic management in asthmatic patients has been focused on avoiding bronchoconstriction and inducing bronchodilation. However, the definition of asthma has changed over the past decade. Asthma has been defined as a clinical syndrome characterized by an inflammatory process that extends beyond the central airways...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: Burburan SM,Xisto DG,Rocco PR

    更新日期:2007-06-01 00:00:00

  • Preoperative autonomic nervous system analysis may stratify the risk of hypotension after spinal anesthesia.

    abstract:BACKGROUND:Studies on pregnant women undergoing cesarean delivery or elderly men scheduled for prostate brachytherapy have demonstrated the predictive value of heart rate variability (HRV) analysis for hypotension during spinal anesthesia. We conducted a prospective observational study to investigate if preoperative HR...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Raimondi F,Colombo R,Spazzolini A,Corona A,Castelli A,Rech R,Borghi B,Fossali T,Guzzetti S

    更新日期:2015-07-01 00:00:00

  • [Use of atracurium for the prevention of fasciculations and succinylcholine myalgia in athletes undergoing orthopedic surgery].

    abstract::The Authors report their clinical experience about the use of atracurium besylate in preventing succinylcholine-induced fasciculations and postoperative myalgias in fifty athletes (ASA class 1), submitted to arthroscopic meniscectomy. The patients were pretreated with atracurium 5 mg i.v. or saline solution in a doubl...

    journal_title:Minerva anestesiologica

    pub_type: 临床试验,杂志文章,随机对照试验,评审

    doi:

    authors: Pagani I,Ramaioli F,Albertario F,Mora R,Dionigi RV

    更新日期:1990-11-01 00:00:00

  • Lactic acidosis.

    abstract::The detection of tissue hypoxia and its correction is one of the aim of the hemodynamic monitoring. Classical hemodynamic variable often fail to achieve this goal. Lactate measurements may be a good indicator of tissue hypoxia. Selected review of the articles on lactate in critically ill patients. Tissue hypoxia is as...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章,评审

    doi:

    authors: De Backer D

    更新日期:2003-04-01 00:00:00

  • [An index of daily intensive care unit activity].

    abstract:OBJECTIVE:To set up an index for the evaluation of type of interventions and procedures applied a prerequisite for the evaluation of appropriateness of ICU's activity. DESIGN:Observation prospective study. PATIENTS:2507 patients out of the 5030 enrolled in the cohort study. MEASUREMENTS:A cross-sectional assessment ...

    journal_title:Minerva anestesiologica

    pub_type: 杂志文章

    doi:

    authors: Rotelli S,Iapichino G,Colombo A,Apolone G,Brazzi L,Calappi E,Leonetti C

    更新日期:1997-11-01 00:00:00