[Comparison of saline, air, and a mixture oxygen-nitrous oxide for endotracheal cuff tracheal tube inflation in children? A prospective randomized trial].
OBJECTIVE
The purpose of the present study was to compare how many inflate and deflate are necessary to maintain the endotracheal tube cuff pressure between 15 and 35 cm H₂O by using air, O₂-N₂O mix or saline solution.


METHODS
Randomized and prospective study.


METHODS
Ninety children from 1 month to 15 years of age were included in the study. All patients were ventilated with O₂50%-N₂O50%. Subsequently, the patients were divided in three groups: (1) Group 1: patients with air inflated cuffs; (2) Group 2: patients with O₂-N₂O mix inflated cuffs; (3) Group 3: patients with saline solution inflated cuffs. In all groups cuffs were inflated to reach an intracuff pressure of 20 cm H₂O. The cuff pressure was then monitored every 10 minutes and adjusted to be between 15 and 35 cm H₂O. Laryngeal and tracheal symptoms were noted in the recovery room.


RESULTS
The three groups of patients were similar for age, weight, and sex. The length of surgery was significantly longer in Group 3. The deflate rate was higher in Group 1 (60%) than in Group 2 (10%) or 3 (3.3%) (p<0.0001). The inflate rate was higher in Group 2 (76.6%) than in Group 1 or 3 (both 3.3%) (p<0.0001). Side effects were comparable in the three groups of patients.


CONCLUSIONS
Using air or O₂-N₂O mix to inflate cuffs is not reliable. SSI helps to maintain a more stable cuff pressure but monitoring is difficult and sometimes contraindicated by tracheal tubes producers. Inflating cuffs with air and regularly monitoring pressure is the most reliable and easiest technique.
Dadure
C
C
Service d'anesthésie-réanimation A, CHU Lapeyronie, avenue du Doyen-Gaston-Giraud, 34000 Montpellier, France. c-dadure@chu-montpellier.fr
Granier
M
M
Bringuier
S
S
Dehour
L
L
Raux
O
O
Rochette
A
A
Troncin
R
R
Capdevila
X
X
D000293:Adolescent; D000388:Air; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D009609:Nitrous Oxide / Q000008:administration & dosage*; D010100:Oxygen / Q000008:administration & dosage*; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*
D012965:Sodium Chloride; D009609:Nitrous Oxide; D010100:Oxygen