Seol G, Jin J, Oh J, Byun SH, Jeon Y. Pressure changes in tapered and cylindrical shaped cuff after extension of head and neck: A randomized controlled trial. World J Clin Cases 2022; 10(31): 11419-11426 [PMID: 36387810 DOI: 10.12998/wjcc.v10.i31.11419]
Corresponding Author of This Article
Younghoon Jeon, MD, PhD, Full Professor, Professor, Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea. jeon68@gmail.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Gukjin Seol, Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu 41944, South Korea
Juhwa Jin, Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital, Daegu 41944, South Korea
Jinyoung Oh, Sung-Hye Byun, Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
Younghoon Jeon, Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu 41944, South Korea
Author contributions: Seol G drafted the manuscript; Jin J performed the research; Oh J was involved with data collection and assisted with data analysis; Byun SH was involved with data collection and assisted data analysis; Jeon Y participated in study design and assisted with data analysis; all authors read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Kyungpook National University Hospital.
Clinical trial registration statement: This study was registered at the ClinicalTrials.GOV (NCT04503031).
Informed consent statement: All patients provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Younghoon Jeon, MD, PhD, Full Professor, Professor, Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea. jeon68@gmail.com
Received: May 20, 2022 Peer-review started: May 20, 2022 First decision: August 21, 2022 Revised: August 31, 2022 Accepted: September 29, 2022 Article in press: September 29, 2022 Published online: November 6, 2022 Processing time: 159 Days and 20.2 Hours
Abstract
BACKGROUND
The proper cuff pressure of endotracheal tube (ET) plays an important role in sealing the airway and preventing airway complications during mechanical ventilation. The ET cuff shape affects the cuff pressure after positional change.
AIM
To investigate cuff pressure between tapered and cylindrical cuff after extension of head and neck during nasal endotracheal intubation.
METHODS
In a randomized clinical trial, 52 patients were randomized to one of two groups: cylindrical cuff or Tapered cuff. Cuff pressure with 22 cmH2O was applied to patients in the neutral position. After extension of head and neck, the cuff pressure was evaluated again and readjusted to 22 cmH2O. In addition, the extent of cephalad migration of ET tip was assessed and postoperative airway complications such as sore throat, and hoarseness were measured.
RESULTS
The cuff pressure was higher in the tapered cuff (28.7 ± 1.0 cmH2O) than in the cylindrical cuff (25.5 ± 0.8 cmH2O) after head and neck extension (P < 0.001). The extent of cephalad migration of tube tip was greater in TaperGuard ET (18.4 ± 2.2 mm) than in conventional ET (15.1 ± 1.2 mm) (P < 0.001). The incidence of postoperative airway complications was comparable between two groups.
CONCLUSION
After head and neck extension, the cuff pressure and the extent of cephalad migration of ET was greater in tapered cuff than in cylindrical cuff during nasal intubation, respectively.
Core Tip: The proper cuff pressure of endotracheal tube is very important in a sealing airway and avoiding airway complication during mechanical ventilation. This was a clinical randomized clinical trial comparing cuff pressure between tapered and cylindrical cuff after head and neck extension during nasal endotracheal intubation. The cuff pressure and the extent of cephalad migration of tube tip was greater in TaperGuard endotracheal tube than in conventional endotracheal tube after head and neck extension, respectively.
