Evaluation of Endotracheal Tube Cuff Pressure and The Use of Three Cuff Inflation Syringe Devices in Dogs

2019-05-15T19:23:52Z (GMT) by Wan-Chu Hung

Over-inflation of an endotracheal tube (ETT) cuff may lead to tracheal necrosis, whereas under- inflation increases the risk of pulmonary aspiration. The objectives of this 2-phase study were to 1) identify the frequency of abnormal ETT cuff inflation in anesthetized dogs, 2) evaluate ETT cuff inflation with 3 devices (regular syringe, Tru-CuffTM syringe, AG Cuffill syringe) in achieving proper cuff pressure (20-30 cmH2O). Dogs undergoing general anesthesia at Purdue Veterinary Medicine Teaching Hospital (PVMTH) were included. The standard operating procedure (SOP) of PVMTH was used for ETT size selection and cuff inflation. The results of objective 1 showed that 50 of the 80 dogs required ETT cuff inflation. Among these 50 dogs, only 14% had proper cuff inflation; 76% of the cuffs were over-inflated and 10% were under-inflated. For objective 2, 90 dogs were equally assigned to the 3 devices for ETT cuff inflation and cuff pressure was assessed with an aneroid manometer. The results showed that 80% of the ETT cuffs were over-inflated with the regular syringe, whereas only 6.7% and 3.3% ETT cuffs were over-inflated with the Tru-CuffTM and AG Cuffill syringes, respectively. The AG Cuffill syringe treatment group had a significantly higher percentage of proper inflated ETT cuffs (86.7%; both p < 0.05) compared to the other two groups (regular [3.3%]; Tru-CuffTM [50%]). We concluded that there was a high frequency of improper ETT cuff inflation when using SOP coupled with a regular syringe. The use of an AG Cuffill syringe significantly reduced improper ETT cuff inflation.