Overinflation of the cuff and pressure on the neck reduce the preventive effect of supraglottic airways on pulmonary aspiration: an experimental study in human cadavers

British Journal of Anaesthesia
Mario HenselT Kerner

Abstract

The oesophageal leak pressure is defined as the pressure which breaks the seal between the cuff of a supraglottic airway and the peri-cuff mucosa, allowing penetration of fluid into the pharynx and the oral cavity. As a consequence, a decrease in this variable increases the risk of reflux and can lead to pulmonary aspiration. The aim of this study was to analyse the effects of cuff overinflation and pressure on the neck on the oesophageal leak pressure of seven supraglottic airways. Three laryngeal masks, two laryngeal tubes, and two oesophageal-tracheal tubes were tested in an experimental setting. In five human cadavers, we simulated a sudden increase in oesophageal pressure. To measure baseline values (control), we used an intracuff pressure as recommended by the manufacturer. The first intervention included overinflation of the cuff by applying twice the amount of pressure recommended. A second intervention was defined as external pressure on the neck. The oesophageal leak pressure was decreased for laryngeal masks (control, 28 cm H2O; overinflation, 9 cm H2O; pressure on the neck, 8 cm H2O; P<0.01) and for laryngeal tubes (control, 68 cm H2O; overinflation, 37 cm H2O; pressure on the neck, 39 cm H2O; P<0.01) and was unaffe...Continue Reading

References

May 1, 1992·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·L IllingR Yip
Nov 24, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·J Brimacombe, C Keller
Feb 13, 2001·The Journal of Emergency Medicine·A M HoB A Tay
Jul 13, 2004·British Journal of Anaesthesia·C KellerA von Goedecke
Mar 11, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Joseph Brimacombe, Christian Keller
Jul 24, 2008·Paediatric Anaesthesia·Ana LicinaBritta S von Ungern-Sternberg
May 18, 2010·Paediatric Anaesthesia·Lisen HockingsBritta S von Ungern-Sternberg
Aug 13, 2010·Acta Anaesthesiologica Scandinavica·A G JensenUNKNOWN Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine
Apr 9, 2014·Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS·Sebastian G Russo, Hinnerk Wulf
Oct 2, 2014·Anaesthesia·M G Irwin, V K F Kong

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Citations

Mar 5, 2017·Journal of Anesthesia·Takashi Asai
Jun 17, 2020·Journal of Clinical Monitoring and Computing·André A J Van ZundertJaideep J Pandit

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