Tracheal sealing characteristics of pediatric cuffed tracheal tubes.
BACKGROUND
The aim of the study was to compare sealing characteristics of the new Microcuff pediatric tracheal tube featuring a high volume-low pressure (HVLP) cuff with ultrathin membrane with three conventional pediatric cuffed tracheal tubes.


METHODS
After obtaining approval of the local ethical committee, 80 children aged 2-4 years were tracheally intubated with the following tubes (i.d. 4.0 mm) in random order: Microcuff P-HVLP, Mallinckrodt Hi-Contour P, Rüschelit Super Safety Clear, and Sheridan CF. Cuff pressure to prevent air leakage at standardized ventilator setting (PIP 20 cm H2O/PEEP 5 cm H2O/RR 20 min(-1)) was assessed within 5 min after intubation by auscultation of audible sounds at the mouth. Cuff pressures required with each group were compared with Kruskall-Wallis test (P < 0.05). Values are median and range.


RESULTS
No significant differences in patient characteristics were found between the four groups. The Microcuff tube required significantly lower sealing pressures [11 cm H2O (6-26)] compared with the other tracheal tube brands [Mallinckrodt: 36 cm H2O (18-48); Rüschelit: 21 cm H2O (8-46); Sheridan: 26 cm H2O (18-60), (P < 0.0001)].


CONCLUSIONS
This preliminary investigation suggests that the new Microcuff pediatric tracheal tube with ultrathin high volume-low pressure cuff membrane allows effective tracheal sealing at very low cuff pressures. This represents a benefit for children with regard to their lower mucosal perfusion pressures compared with adult patients.
Dullenkopf
Alexander
A
Department of Anaesthesia, University Children's Hospital Zurich, Switzerland.
Schmitz
Achim
A
Gerber
Andreas C
AC
Weiss
Markus
M
D001314:Auscultation; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000295:instrumentation; D008297:Male; D011312:Pressure; D014132:Trachea / Q000502:physiology*