Your browser doesn't support javascript.
loading
Overinflation of the cuff and pressure on the neck reduce the preventive effect of supraglottic airways on pulmonary aspiration: an experimental study in human cadavers.
Hensel, M; Schmidbauer, W; Geppert, D; Sehner, S; Bogusch, G; Kerner, T.
Afiliação
  • Hensel M; Department of Anaesthesiology and Intensive Care Medicine, Chefarzt der Abteilung Anästhesiologie und Intensivmedizin, Park-Klinik-Weissensee, Schönstrasse 80, Berlin 13086, Germany hensel@park-klinik.com.
  • Schmidbauer W; Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine, Combat Search and Rescue Bundeswehrkrankenhaus, Berlin 10115, Germany.
  • Geppert D; Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Asklepios Klinik Nord Heidberg, Hamburg 22417, Germany.
  • Sehner S; Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Hamburg 20246, Germany.
  • Bogusch G; Center for Anatomy, Charité-Universitätsmedizin, Berlin 10117, Germany.
  • Kerner T; Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Asklepios Klinikum Harburg, Hamburg 21075, Germany.
Br J Anaesth ; 116(2): 289-94, 2016 Feb.
Article em En | MEDLINE | ID: mdl-26787800
ABSTRACT

BACKGROUND:

The oesophageal leak pressure is defined as the pressure which breaks the seal between the cuff of a supraglottic airway and the peri-cuff mucosa, allowing penetration of fluid into the pharynx and the oral cavity. As a consequence, a decrease in this variable increases the risk of reflux and can lead to pulmonary aspiration. The aim of this study was to analyse the effects of cuff overinflation and pressure on the neck on the oesophageal leak pressure of seven supraglottic airways.

METHODS:

Three laryngeal masks, two laryngeal tubes, and two oesophageal-tracheal tubes were tested in an experimental setting. In five human cadavers, we simulated a sudden increase in oesophageal pressure. To measure baseline values (control), we used an intracuff pressure as recommended by the manufacturer. The first intervention included overinflation of the cuff by applying twice the amount of pressure recommended. A second intervention was defined as external pressure on the neck.

RESULTS:

The oesophageal leak pressure was decreased for laryngeal masks (control, 28 cm H2O; overinflation, 9 cm H2O; pressure on the neck, 8 cm H2O; P<0.01) and for laryngeal tubes (control, 68 cm H2O; overinflation, 37 cm H2O; pressure on the neck, 39 cm H2O; P<0.01) and was unaffected for oesophageal-tracheal tubes (control, 126 cm H2O; overinflation/pressure on the neck, 130 cm H2O; n.s.).

CONCLUSION:

Cuff overinflation and pressure on the neck can enhance the risk of gastro-oesophageal reflux when using supraglottic airways. Therefore, both manoeuvres should be avoided in clinical practice.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Máscaras Laríngeas / Aspiração Respiratória / Intubação Intratraqueal / Pescoço Tipo de estudo: Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Br J Anaesth Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Máscaras Laríngeas / Aspiração Respiratória / Intubação Intratraqueal / Pescoço Tipo de estudo: Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Br J Anaesth Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Alemanha