title: The effects of extubation with an inflated versus deflated endotracheal tube cuff on endotracheal fluid volume in the dog.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effect of extubation with the endotracheal tube (ETT) cuff inflated versus deflated on endotracheal fluid volume in normal canine cadavers.
  
  
  METHODS
  Prospective randomized blinded controlled cadaver study.
  
  
  METHODS
  Sixteen adult Beagle cadavers weighing 10.7 ± 1.7 kg (mean ± SD) and <2 years of age.
  
  
  METHODS
  Cadavers were orotracheally intubated in lateral recumbency, and the ETT cuffs were inflated to a closing pressure of 20 cm H2O before barium was introduced orad to the cuff. The dogs were randomly assigned to an ETT cuff extubation condition of deflated or unchanged from the original closing pressure. After extubation, lateral thoracic radiographs of the cadavers were obtained and scored by three independent blinded reviewers. Each reviewer ordered all 16 lateral radiographs from most to least intratracheal contrast and also estimated residual intratracheal contrast volume.
  
  
  RESULTS
  Dogs extubated with a deflated ETT cuff had a median rank of 13 and dogs extubated with an inflated ETT cuff had a median rank of 4.5 (p<0.0001). Dogs extubated with a deflated ETT cuff had an estimated intratracheal volume of fluid of 1.8 mL ± 0.7 mL (mean ± SD) and dogs extubated with an inflated ETT cuff had an estimated volume of 0.9 mL ± 0.5 mL (p < 0.0001). Fleiss Kappa for agreement among evaluators was 0.875.
  
  
  CONCLUSIONS
  Extubation with the cuff inflated removed more liquid contents from the trachea than extubation with the cuff deflated and may assist in the prevention of pulmonary aspiration when fluid is present in the proximal trachea. The technique did not remove all fluid so the potential for pulmonary damage remains.
authors.affiliation: College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Vance
authors.forename: Erik H
authors.initials: EH
authors.lastname: Hofmeister
authors.forename: Cody
authors.initials: C
authors.lastname: Laas
authors.forename: Jamie
authors.initials: J
authors.lastname: Williams
mesh_terms: D000818:Animals; D004285:Dogs; D005260:Female; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D011446:Prospective Studies; D011859:Radiography; D011897:Random Allocation; D053120:Respiratory Aspiration / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control / Q000662:veterinary*; D016037:Single-Blind Method; D014132:Trachea / Q000000981:diagnostic imaging