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Comparison of a Novel Lycra Endotracheal Tube Cuff to Standard Polyvinyl Chloride Cuff and Polyurethane Cuff for Fluid Leak Prevention

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BACKGROUND: A high-volume low-pressure endotracheal tube (ETT) cuff forms folds along its contact with the trachea, allowing mucus leakage into the lungs. We developed a thin-walled ETT cuff made of Lycra polyurethane. METHODS: In vitro, we tested 6 of each of the new prototype Lycra cuff, the Mallinkrodt Hi-Lo ETT (polyvinyl chloride cuff), and the Kimberly-Clark Microcuff ETT (polyurethane cuff), for leakage, in an acrylic mock trachea (inner diameter 20-mm), with a cuff inflation pressure of 20 cm H2O. We poured 15 mL of methylene-blue colored water into the acrylic tube above the cuff and observed for leakage for 24 hours. RESULTS: The Lycra cuffs had no folds upon inflation in the mock trachea and completely prevented fluid leakage for 24 hours (P < .001 vs the Hi-Lo and the Microcuff). The average leakage past the Hi-Lo was 1,182 ± 1,321 mL/h. The average leakage past the Microcuff was 1.2 ± 0.4 mL/h (P < .001 vs the Hi-Lo). CONCLUSIONS: Our Lycra cuff provided complete tracheal sealing in vitro.

Keywords: cuff; endotracheal tube; mechanical ventilation; ventilator; ventilator-associated pneumonia

Document Type: Research Article

DOI: http://dx.doi.org/10.4187/respcare.01099

Affiliations: Section of Pulmonary and Cardiac Assist Devices, Pulmonary and Critical Care Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA

Publication date: August 1, 2011

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