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
Anaesthesiajournal_title
Anaesthesiaauthors
Ong M,Chambers NA,Hullet B,Erb TO,von Ungern-Sternberg BSdoi
10.1111/j.1365-2044.2008.05486.xsubject
Has Abstractpub_date
2008-07-01 00:00:00pages
738-44issue
7eissn
0003-2409issn
1365-2044pii
ANA5486journal_volume
63pub_type
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