Laryngeal mask airway and tracheal tube cuff pressures in children: are clinical endpoints valuable for guiding inflation?

Abstract:

:We prospectively assessed common clinical endpoints for their usefulness in avoiding hyperinflation of the cuffs of laryngeal mask airways (slight outward movement) and tracheal tubes (disappearance of an audible leak around the cuff during manual ventilation < 20 cm H(2)O) in 640 children. Cuff pressures were measured at induction and immediately before emergence from anaesthesia. With the laryngeal mask airway (sizes 1-4), the median cuff pressures ranged from 90 to > 120 cm H(2)O at induction and 105 to > 120 cm H(2)O before emergence. With tracheal tubes (sizes 3-7 mm), median cuff pressures were 40-60 cm H(2)O at induction and 45-70 cm H(2)O at emergence. With the use of nitrous oxide a consistent rise in cuff pressure was observed between the first and second readings whereas cuff pressures remained constant when nitrous oxide was not used. The use of clinical endpoints alone was associated with significant hyperinflation of cuffs with both devices in almost all patients, with an exacerbation when nitrous oxide was used. In order to avoid unnecessary cuff hyperinflation in laryngeal mask airways and tracheal tubes, the routine use of cuff manometers is mandatory in children.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Ong M,Chambers NA,Hullet B,Erb TO,von Ungern-Sternberg BS

doi

10.1111/j.1365-2044.2008.05486.x

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

738-44

issue

7

eissn

0003-2409

issn

1365-2044

pii

ANA5486

journal_volume

63

pub_type

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