title: Effectiveness of the endotracheal tube cuff on the trachea: physical and mechanical aspects.
abstract: BACKGROUND
  The inflation pressure of the endotracheal tube cuff can cause ischemia of the tracheal mucosa at high pressures; thus, it can cause important tracheal morbidity and tracheal microaspiration of the oropharyngeal secretion, or it can even cause pneumonia associated with mechanical ventilation if the pressure of the cuff is insufficient.
  
  
  OBJECTIVE
  In order to investigate the effectiveness of the RUSCH® 7.5 mm endotracheal tube cuff, this study was designed to investigate the physical and mechanical aspects of the cuff in contact with the trachea.
  
  
  METHODS
  For this end, we developed an in vitro experimental model to assess the flow of dye (methylene blue) by the inflated cuff on the wall of the artificial material. We also designed an in vivo study with 12 Large White pigs under endotracheal intubation. We instilled the same dye in the oral cavity of the animals, and we analyzed the presence or not of leakage in the trachea after the region of the cuff after their deaths (animal sacrifice). All cuffs were inflated at the pressure of 30 cmH2O.
  
  
  RESULTS
  We observed the passage of fluids through the cuff in all in vitro and in vivo experimental models.
  
  
  CONCLUSIONS
  We conclude that, as well as several other cuff models in the literature, the RUSCH® 7.5 mm tube cuffs are also not able to completely seal the trachea and thus prevent aspiration of oropharyngeal secretions. Other prevention measures should be taken.
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Maira Soliani Del
authors.initials: MS
authors.lastname: Negro
authors.affiliation: Centro Médico de Campinas, Campinas, SP, Brazil.
authors.forename: Gilson
authors.initials: G
authors.lastname: Barreto
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Raíssa Quaiatti
authors.initials: RQ
authors.lastname: Antonelli
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Tiago Antônio
authors.initials: TA
authors.lastname: Baldasso
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Luciana Rodrigues de
authors.initials: LR
authors.lastname: Meirelles
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Marcos Mello
authors.initials: MM
authors.lastname: Moreira
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Alfio José
authors.initials: AJ
authors.lastname: Tincani
mesh_terms: D000818:Animals; D004867:Equipment Design; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D023421:Models, Animal; D011312:Pressure; D015203:Reproducibility of Results; D012121:Respiration, Artificial / Q000379:methods; D063466:Respiratory Aspiration of Gastric Contents / Q000517:prevention & control; D013552:Swine; D013997:Time Factors; D014132:Trachea / Q000601:surgery*