Comparison of Microaspiration Around Taperguard Tube Cuffs and Standard Tracheal Tubes in Obese Patients Subjected to Surgery Under General Anesthesia

• Authors: Ewelina Gaszyńska , Paweł Ratajczyk , Andrzej Wieczorek , Tomasz Szewczyk , Tomasz Gaszyński
• Languages of publication: EN

Abstracts

EN

Tracheal secretion leakage might lead to ventilator-associated pneumonia. Standard tracheal tube cuffs are cylindrical in shape. Bronchial tree aspiration is observed in the presence of leakage past tracheal tube cuffs. The new TaperGuard tracheal tube has a cuff in the shape of a cone, preventing from the development of microtubules and microaspiration. The aim of the study was to compare standard tracheal tube cuffs with TaperGuard tubes, in terms of protection from microaspiration under general anesthesia. Material and methods. The observational study evaluated incidents of leakage during general anesthesia with intubation and mechanical ventilation in patients with significant obesity. The study group comprised 20 patients with the BMI >40 kg/m2 subjected to elective surgery under general anesthesia with intubation and mechanical ventilation, randomly divided into two subgroups: standard tracheal tube and TaperGuard tube. Results. In 4 of 10 patients with standard tracheal tubes we observed leakage around the cuff. In case of TaperGuard tubes no such leakage was observed. Conclusion. TaperGuard tubes protect against microaspirations, while standard tracheal tubes have no such properties.

Keywords

EN

endotracheal intubation; general anesthesia; tracheal tubes; cuff tightness; microaspirations; ventilator-associated pneumonia

• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 86
• Issue: 3
• Pages: 107-110

Dates

published

1 - 3 - 2014

received

23 - 7 - 2013

online

25 - 4 - 2014

Contributors

author

Ewelina Gaszyńska

• Department of Hygiene and Health Promotion, Medical University in Łódź Kierownik: prof. dr hab. F. Szatko

author

Paweł Ratajczyk

• Chair and Department of Anesthesiology and Intensive Therapy, Medical University in Łódź Kierownik: prof. dr hab. W. Gaszyński

author

Andrzej Wieczorek

• Chair and Department of Anesthesiology and Intensive Therapy, Medical University in Łódź Kierownik: prof. dr hab. W. Gaszyński

author

Tomasz Szewczyk

• Department of Gastroenterological, Oncological and General Surgery, Medical University in Łódź p.o. Kierownika: prof. dr hab. J. Strzelczyk

author

Tomasz Gaszyński

• Department of Emergency Medicine and Disaster Medicine, Medical University in Łódź Kierownik: dr hab. T. Gaszyński, prof. nadzw.,

References

• 1. Janda M, Scheeren TW , Noldge-Schomburg GF: Management of pulmonary aspiration. Best Pract Res Clin Anaesthesiol 2006; 20: 409-27.[Crossref][PubMed]
• 2. Dullenkopf A, Gerber A, Weiss M: Fluid leakage past tracheal tube cuffs: evaluation of the new Microcuff endotracheal tube. Intensive Care Med 2003; 29: 1849-53.[Crossref]
• 3. Kalinowski CP, Kirsch JR: Strategies for prophylaxis and treatment for aspiration. Best Pract Res Clin Anaesthesiol 2004; 18: 719-37.[PubMed][Crossref]
• 4. Lawrence VA, Hilsenbeck SG, Mulrow CD et al.: Incidence and hospital stay for cardiac and pulmonary complications after abdominal surgery. J Gen Intern Med 1995; 10: 671-78.[Crossref]
• 5. Thompson DA , Makary MA , Dorman T, Pronovost PJ: Clinical and economic outcomes of hospital acquired pneumonia in intra-abdominal surgery patients. Ann Surg 2006; 243(4): 547-52.
• 6. Safdar N, Crnich CJ , Maki DG: The pathogenesis of ventilator-associated pneumonia: its relevance to developing effective strategies for prevention. Respir Care 2005; 50(6): 725-39.[PubMed]
• 7. Chastre J, Fagon JY : Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002; 165: 867-903.
• 8. Arozullah AM , Khuri SF, William G et al.: Development and validation of a multifactorial risk index for predicting postoperative pneumonia after major noncardiac surgery. Ann Intern Med 2001; 135: 847-57.
• 9. Szlachciński Ł, Gaszyński T, Gaszyński W: Ocena wypełnienia mankietu uszczelniającego rurki intubacyjnej przez personel anestezjologiczny. Anestezjologia i Ratownictwo 2011; 5: 28-32.
• 10. Dullenkopf A, Schmitz A, Frei M et al.: Air leakage around endotracheal tube cuffs. Eur J Anaesthesiol 2004; 21: 448-53.[Crossref]
• 11. Oikkonen M, Aromaa U: Leakage of fluid around low-pressure tracheal tube cuffs. Anesthesia 1997; 52: 567-69.[PubMed]

Identifiers

DOI

10.2478/pjs-2014-0020