Abstract
Objective
The effect of user experience and inflation technique on endotracheal tube cuff pressure
using a feline airway simulator.
Study design
Prospective, experimental clinical study.
Methods
Participants included veterinary students at the beginning (group S1) and end (group
S2) of their 2-week anaesthesia rotation and veterinary anaesthetists (group A). The
feline airway simulator was designed to simulate an average size feline trachea, intubated
with a 4.5 mm low-pressure, high-volume cuffed endotracheal tube, connected to a Bain
breathing system with oxygen flow of 2 L minute−1. Participants inflated the on-endotracheal tube cuff by pilot balloon palpation and
by instilling the minimum occlusive volume (MOV) required for loss of airway leaks
during manual ventilation. Intracuff pressures were measured by manometers obscured
to participants and ideally were 20–30 cm H2O. Student t, Fisher exact, and Chi-squared tests were used where appropriate to analyse data
(p < 0.05).
Results
Participants were 12 students and eight anaesthetists. Measured intracuff pressures
for palpation and MOV, respectively, were 19 ± 12 and 29 ± 19 cm H2O for group S1, 10 ± 5 and 20 ± 11 cm H2O for group S2 and 13 ± 6 and 29 ± 18 cm H2O for group A. All groups performed poorly at achieving intracuff pressures within
the ideal range. There was no significant difference in intracuff pressures between
techniques. Students administered lower (p = 0.02) intracuff pressures using palpation after their training.
Conclusions and clinical relevance
When using palpation and MOV for cuff inflation operators rarely achieved optimal
intracuff pressures. Experience had no effect on this skill and, as such, a cuff manometer
is recommended.
Keywords
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Article info
Publication history
Published online: February 23, 2017
Accepted:
November 29,
2016
Received:
June 3,
2016
Identification
Copyright
© 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
