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Intracuff Pressure (intracuff + pressure)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

The Laryngeal Mask Airway SupremeTM, a single use laryngeal mask airway with an oesophageal vent.

ANAESTHESIA, Issue 1 2009
A randomised, anaesthetised patients, cross-over study with the Laryngeal Mask Airway ProSealTM in paralysed
Summary The LMA SupremeTM is a new extraglottic airway device which brings together features of the LMA ProSealTM, FastrachTM and UniqueTM. We test the hypothesis that ease of insertion, oropharyngeal leak pressure, fibreoptic position and ease of gastric tube placement differ between the LMA ProSealTM and the LMA SupremeTM in paralysed anesthetised patients. Ninety-three females aged 19,71 years were studied. Both devices were inserted into each patient in random order. Two attempts were allowed. Digital insertion was used for the first attempt and guided insertion for the second attempt. Oropharyngeal leak pressure and fibreoptic position were determined during cuff inflation from 0 to 40 ml in 10 ml increments. Gastric tube insertion was attempted if there was no gas leak from the drain tube. First attempt and overall insertion success were similar (LMA ProSealTM, 92% and 100%; LMA SupremeTM 95% and 100%). Guided insertion was always successful following failed digital insertion. Oropharyngeal leak pressure was 4,8 ml higher for the LMA ProSealTM over the inflation range (p < 0.001). Intracuff pressure was 16,35 cm higher for the LMA ProSealTM when the cuff volume was 20,40 ml (p < 0.001). There was an increase in oropharyngeal leak pressure with increasing cuff volume from 10 to 30 ml for both devices, but no change from 0 to 10 ml and 30,40 ml. There were no differences in the fibreoptic position of the airway or drain tube. The first attempt and overall insertion success for the gastric tube was similar (LMA ProSealTM 91% and 100%; LMA SupremeTM 92% and 100%). We conclude that ease of insertion, gastric tube placement and fibreoptic position are similar for the LMA ProSealTM and LMA SupremeTM in paralysed, anaesthetised females, but oropharyngeal leak pressure and intracuff pressure are higher for the LMA ProSealTM. [source]

An evaluation of the Airway Management Device

ANAESTHESIA, Issue 7 2001
apparatus
We have evaluated the Airway Management Device (AMDÔ) in 105 anaesthetised patients. We were successful in establishing a clear airway on the first attempt on 69 occasions and unable to establish a patent airway at all in 10 patients. Airway obstruction requiring removal of the device occurred during maintenance of anaesthesia in a further two cases and during emergence in three. Loss of the airway during anaesthesia occurred in eight of 95 patients and could be reversed by manipulation of the airway in six cases. Overall, a mean of 0.56 manipulations per patient were required to establish an airway and a further 0.42 per patient were required during maintenance of anaesthesia. In the 95 patients in whom an airway was established, assisted ventilation was satisfactory in 93, with a leak pressure above 20 cmH2O in 65. Intracuff pressure was measured in 12 cases and was above 100 cmH2O in eight. Minor complications occurred in 12 patients. Blood was visible on removal of the device in six cases. [source]

A new supraglottic airway device: LMA-SupremeÔ, comparison with LMA-ProsealÔ

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2009
T. HOSTEN
Background and objective: The LMA-SupremeÔ (S-LMAÔ) is a new supraglottic airway device that presents combined features of flexibility, curved structure and single use and a different cuff structure. The purpose of this study was to compare the oropharyngeal leak pressures (OLP) of LMA-ProsealÔ (P-LMAÔ) and S-LMAÔ. Methods: Sixty adult patients were prospectively and randomly allocated to undergo insertion of P-LMAÔ (n=30) or S-LMAÔ (n=30). The cuffs were inflated until the intracuff pressure (ICP) reached 60 cm H2O. Orogastric leak pressures, insertion times, first attempt success rates, fiberoptical assessment of position, cuff pressures, orogastric tube (OGT) placement and OGT insertion times were compared. Unblinded observers collected intraoperative data and blinded observers collected post-operative data. Results: The first insertion attempts and time taken to provide an effective airway were similar between the groups. Two patients (P-LMAÔ, n=1; S-LMAÔ, n=1) were intubated due to excessive oropharyngeal leak and in one patient (P-LMAÔ, n=1) due to failed OGT placement. OLPs were similar (P-LMAÔ; 26.9±6.6 S-LMAÔ; 26.1±5.2). ICP increased significantly in the P-LMAÔ at the 30 and 60 min during anesthesia (P-LMAÔ; 80.1±12.8, 92.9±14.4, S-LMAÔ; 68.3±10.9, 73.7±15.6). OGT placement was successful in all patients in the S-LMAÔ, but failed in five patients in the P-LMAÔ (P=0.02). Fiberoptically determined anatomic position was better with the P-LMAÔ (P=0.03). Conclusion: Our findings suggest that S-LMAÔ had leak pressures similar to the P-LMAÔ, and this new airway device proved to be successful during both spontaneous and positive pressure ventilation. [source]

Cuff compliance of pediatric and adult cuffed tracheal tubes: an experimental study

PEDIATRIC ANESTHESIA, Issue 8 2004
J.-M. Devys MD
Summary Background :,Tracheal mucosal damage related to tracheal intubation has been widely described in pediatric and adult patients. High volume,low pressure cuffs (HVLPC) are being advertised as safe to avoid this particularly unpleasant complication. Compliances of these supposed pediatric and adult HVLPC are not mentioned by manufacturers and still remain unknown. Methods :,The compliance of HVLPC was measured in vitro and defined as the straight portion of the pressure,volume curve. Cuff pressure was measured after incremental 0.1 ml filling volumes of air for sizes 3.0,8.0 of internal diameter of RüschTM and MallinckrodtTM tracheal tubes. Compliances were assessed in air and in a rigid tube. The filling volume to achieve a 25-mmHg intracuff pressure was also measured. Results :,In air, each 0.1 ml step almost linearly increased cuff pressure by 1 mmHg (size 8.0) to 9 mmHg (size 3). In air, the volume needed to maintain a cuff pressure < 25 mmHg was small for sizes 3,5.5 (0.35,2 ml). The 25 mmHg inflated cuff volume and compliance were decreased within a rigid tube, especially for adult sizes. In a rigid tube simulating a trachea, the compliances of almost every RüschTM tracheal tube were statistically higher than those of the MallinckrodtTM. Conclusion :,We conclude that the tested tracheal tube cuffs have low compliance and cannot be defined as high volume,low pressure. [source]

The Laryngeal Mask Airway SupremeTM, a single use laryngeal mask airway with an oesophageal vent.

Leakage of fluid around high-volume, low-pressure cuffs

ANAESTHESIA, Issue 1 2001
apparatus
We studied the ability of high-volume, low-pressure tracheal tube cuffs (Portex Soft Seal®, Portex Profile®, Mallinckrodt Lo-Contour® and Mallinckrodt Hi-Lo® tubes) to prevent leakage of fluid into the airway, in a model trachea and lung. Five tubes (7.0 and 8.0 mm internal diameter) of each type were used. Each tube was inserted into the model trachea and the cuff inflated until the intracuff pressure reached either 20, 30 or 40 cmH2O. The model lung was ventilated with a tidal volume of 700 ml and respiratory rate of 14 breath.min,1 at a compliance of 20 cmH2O. Ten millilitres of 0.01% methylene blue solution were infused over the cuff and the volume of fluid leaking past the cuff over 5 min was measured. The leak volume for the Soft Seal tube was less than that for the Profile or Lo-Contour tubes at all intracuff pressures (all p <,0.05). Compared with the Hi-Lo tube, the volume leaking past the cuff for the Soft Seal tube was greater at an intracuff pressure of 20 cmH2O (p <,0.05), whereas there was no significant difference between these two tubes at an intracuff pressure of 30 or 40 cmH2O. We conclude that the cuff of the Portex Soft Seal tube prevented leakage of fluid significantly more than that of the Portex Profile or Mallinckrodt Lo-Contour tubes, and to a similar degree to that of the Mallinckrodt Hi-Lo tube. [source]

Pressure volume curves of paediatric laryngeal mask airways

ANAESTHESIA, Issue 5 2009
C. J. Wallace
Summary Hyperinflation of the laryngeal mask airway cuff may exert high pressure on pharyngeal and laryngeal structures. In vitro data show that high intra cuff pressures may occur when inflated to only 30% of the manufacturer's recommended maximum inflation volume. We prospectively assessed the pressure volume curves of paediatric sized laryngeal mask airways (size 1,3) in 240 consecutive children (0,15 years). Following laryngeal mask airway insertion the cuff was inflated with 1-ml increments of air up to the maximum recommended by the manufacturer. After each ml cuff pressure was measured. At the end all cuff pressures were adjusted to 55 cmH2O. The maximum recommended volume resulted in high intracuff pressures in all laryngeal mask airway brands and sizes studied. Approximately half the maximum volume produced a cuff pressure , 60 cmH2O. This occurred in all brands and all sizes studied. We recommend that cuff manometers should be used to guide inflation in paediatric laryngeal mask airways. [source]