2011 OPEN FORUM Abstracts
A BENCH-TOP MODEL: THE COMPARISON OF LEAKAGE OCCURRENCE AROUND ENDOTRACHEAL TUBE CUFFS IN CONVENTIONAL ENDOTRACHEAL TUBES AND THOSE NEWLY DESIGNED TO PREVENT MICRO-ASPIRATION.
Crystal Frey, Sarah Garrison, Valerie Hathaway, Alicia Schroeder; Saint Catherine University, Saint Paul, MN
BACKGROUND: Because ventilator-associated pneumonia (VAP) affects up to 25 percent of intubated patients receiving mechanical ventilation for greater than 48 hours, endotracheal tube (ETT) manufacturers have designed new innovative technology that is targeted towards decreasing the risk of micro-aspiration and, in turn, decreasing instances of VAP. OBJECTIVE: An in vitro study was designed in order to compare conventional ETTs with newly designed ETTs and to determine their cuffs effectiveness at decreasing leakage of fluid around the cuff. METHODS: Three types of conventional ETTs (Mallinckrodt HiLo, Portex Profile Soft Seal, Sheridan/HVT) were studied and compared with three types of ETTs that feature new technology (Kimberly-Clark MicroCuff, Mallinckrodt HiLo Evac, Mallinckrodt HiLo TaperGuard Evac). Trachea models were constructed using 6" of 22mm tubing with smooth interior corrugation that fit into a plastic denture cup to act as a stand and a reservoir for leakage. The ETT cuffs were placed into the trachea model and were inflated to either 28 cmH2O or 64 cmH2O. Dyed liquid was instilled above the cuffs and the ETTs were observed for time at total leakage. RESULTS: A large standard deviation was calculated, signifying a wide range of variation in time until total leakage occurred in each different type of ETT. It was found that the MicroCuff provided the best seal for the longest time at both pressures. CONCLUSION: Because there was a significant difference between the effectiveness of the MicroCuff in preventing cuff leakage and the conventional ETTs, it was concluded that newly designed ETT’s and cuffs prove to have some potential. Keywords: Endotracheal tube (ETT), cuffs, leakage, aspiration, Ventilator-Associated Pneumonia (VAP), polyurethane cuff, Benchmark model, trachea. Sponsored Research – None