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Cuff deflation

Keiko Imai, Taku Doi, Kenji Kayashima
We experienced difficulty inserting cuffed inner diameter (ID) 4.5- and 5.0-mm endotracheal tubes (ETTs) in a 5-year-old boy. Postoperative ultrasound investigations showed that the internal transverse width of the cricoid cartilage was 8.0 mm. The maximum outer diameter (OD) of the deflated cuff portion of the cuffed ID 4.5- and 5.0-mm ETTs was 8.5 and 9.6 mm, respectively. The OD of an uncuffed ID 5.5-mm ETT was 7.6 mm; this tube passed the cricoid cartilage. Hence, the transverse width of the cricoid cartilage and ETT diameter including cuff folds should be considered when selecting cuffed ETTs...
October 5, 2016: A & A Case Reports
Darío Villalba, Viviana Feld, Valeria Leiva, Mariana Scrigna, Eduardo Distéfano, Romina Pratto, Matías Rodriguez, Jesica Collins, Ana Rocco, Amelia Matesa, Damián Rossi, Laura Areas, Sacha Virgilio, Nicolás Golfarini, Gregorio Gil-Rosetti, Pablo Diaz-Ballve, Fernando Planells
OBJECTIVE: To describe and compare the work of breathing (WOB) during spontaneous breathing under four conditions: (1) breathing through a tracheostomy tube with an inflated cuff, (2) breathing through the upper airway (UA) with a deflated cuff and occluded tube, (3) breathing through the UA with an occluded cuffless tube, and (4) postdecannulation. PATIENTS AND METHODS: Patients who tolerated an occluded cuffless tube were included. Ventilatory variables and esophageal pressure were recorded...
July 2016: International Journal of Critical Illness and Injury Science
Felipe D Lisbôa, Tiago Turnes, Rogério S O Cruz, João A G Raimundo, Gustavo S Pereira, Fabrizio Caputo
OBJECTIVES: The present study aimed to determine the effects of ischemic preconditioning on performance in three successive 50-m swimming trials and to measure stroke rate, stroke length and blood lactate accumulation. DESIGN: Counterbalanced, repeated-measures cross-over study. METHODS: On two separate days, eleven competitive male swimmers (20±3 years, 182±5cm, 77±5kg) performed three successive 50-m trials in a 50-m swimming pool, preceded by intermittent bilateral cuff inflation (4× 5-min of blood flow restriction+5-min of cuff deflation) at either 220 for thighs and 180mmHg for arms (ischemic preconditioning) or 20mmHg for both limbs (control-treatment)...
September 20, 2016: Journal of Science and Medicine in Sport
David Eisenbrey, Arthur B Eisenbrey, Patrick Pettengill
Endotracheal tubes are intended to protect the airway and assist with mechanical ventilation in sedated patients. The blood vessels of the tracheal mucosa can be compressed by high tracheal tube cuff pressures (> 30 cm H2O), leading to reduced mucosal blood flow with resulting ischemia and morbidity. Previous research showed a direct correlation between aircraft pressure altitude and the pressure reading from the tracheal cuff, with resulting pressures > 80 cm H2O at 10,000 ft. Standard practice is to periodically remove air from the cuff during ascent based on assumed increased pressure on the adjacent tracheal mucosa...
September 2016: Air Medical Journal
Ali Akbar Jafarian, Farnad Imani, Reza Salehi, Farid Najd Mazaher, Fatemeh Moini
BACKGROUND: Intravenous Regional Anesthesia (IVRA) is a well-known technique for producing analgesia during surgical procedures in the extremities. However, the rapid onset of pain following the deflation of a double-cuff tourniquet during IVRA is a serious disadvantage, leading patient suffering. OBJECTIVES: The aim of this study was to evaluate the clinical effectiveness of a pneumatic arm tourniquet applied 2 cm above the double-cuff tourniquet in controlling the pain that occurs after its deflation...
June 2016: Anesthesiology and Pain Medicine
Amir C Dayan, Richard H Epstein
BACKGROUND: An intact pilot balloon assembly is crucial to the proper function of a cuffed tracheal tube. Disruption of the pilot balloon, transection of the inflation line, or valve incompetence results in cuff deflation, which may lead to inadequate ventilation and aspiration of secretions. Such failures typically result in tracheal tube replacement, but this may be a safety risk if a difficult reintubation is anticipated. We recently encountered such a patient who remained intubated postoperatively and in whom the inflation line was transected, causing a large leak...
September 7, 2016: Anesthesia and Analgesia
Deb Sanjay Nag, Devi Prasad Samaddar
We discuss a case of difficult extubation, due to inadequate deflation of the tracheal tube cuff, despite collapse of the pilot balloon, on its aspiration. This was caused by inadvertent kinking of the pilot balloon tubing due to inappropriate tape fixation of the endotracheal tube.
September 2016: Brazilian Journal of Anesthesiology
Ruth F Dubin, Isabella Guajardo, Amrita Ayer, Claire Mills, Catherine Donovan, Lauren Beussink, Rebecca Scherzer, Peter Ganz, Sanjiv J Shah
Patients with end-stage renal disease (ESRD) suffer high rates of heart failure and cardiovascular mortality, and we lack a thorough understanding of what, if any, modifiable factors contribute to cardiac dysfunction in these high-risk patients. To evaluate endothelial function as a potentially modifiable cause of cardiac dysfunction in ESRD, we investigated cross-sectional associations of macro- and microvascular dysfunction with left and right ventricular dysfunction in a well-controlled ESRD cohort. We performed comprehensive echocardiography, including tissue Doppler imaging and speckle-tracking echocardiography of the left and right ventricle, in 149 ESRD patients enrolled in an ongoing prospective, observational study...
October 2016: Hypertension
Mitchel R Stacy, Christopher M Caracciolo, Maolin Qiu, Prasanta Pal, Tyler Varga, Robert Todd Constable, Albert J Sinusas
Blood oxygen level-dependent (BOLD) magnetic resonance (MR) imaging permits noninvasive assessment of tissue oxygenation. We hypothesized that BOLD imaging would allow for regional evaluation of differences in skeletal muscle oxygenation between athletes and sedentary control subjects, and dynamic BOLD responses to ischemia (i.e., proximal cuff occlusion) and reactive hyperemia (i.e., rapid cuff deflation) would relate to lower extremity function, as assessed by jumping ability. College football athletes (linemen, defensive backs/wide receivers) were compared to sedentary healthy controls...
August 2016: Physiological Reports
Ruijuan Han, Xiaoqing Liu, XianDong Yin, Meili Zheng, Kai Sun, Xingpeng Liu, Ying Tian, Xinchun Yang
BACKGROUND: Remote ischemic preconditioning (RIPC) has been suggested to reduce postoperative release of cardiac and inflammatory markers in patients undergoing cardiac surgery. This study aimed to evaluate the effect of RIPC on nonischemic myocardial damage and inflammatory response in patients undergoing radiofrequency catheter ablation for paroxysmal atrial fibrillation (AF). METHODS: Seventy-two patients with drug-refractory paroxysmal AF undergoing radiofrequency catheter ablation were randomized into RIPC or control groups...
November 1, 2016: International Journal of Cardiology
Yali Zheng, Carmen C Y Poon, Bryan P Yan, James Y W Lau
Ambulatory blood pressure monitoring (ABPM) has become an essential tool in the diagnosis and management of hypertension. Current standard ABPM devices use an oscillometric cuff-based method which can cause physical discomfort to the patients with repeated inflations and deflations, especially during nighttime leading to sleep disturbance. The ability to measure ambulatory BP accurately and comfortably without a cuff would be attractive. This study validated the accuracy of a cuff-less approach for ABPM using pulse arrival time (PAT) measurements on both healthy and hypertensive subjects for potential use in hypertensive management, which is the first of its kind...
September 2016: Journal of Medical Systems
Nicolas W Shammas, Mary F Knowles, W John Shammas, William Hauber, Gail A Shammas, Melissa J Green, Julie Dokas
BACKGROUND: The optimal technique to detect venous reflux requires a patient to be standing with weight on one leg while the other leg is scanned for superficial venous reflux (standing position [SP] technique). This represents a significant hardship for a subset of patients who are unable to stand and adequately maintain their balance. This study examines the predictability of identifying venous reflux using a reverse Trendelenburg 60° (RT-60) when compared with the SP in the great saphenous vein (GSV) and small saphenous vein (SSV)...
September 2016: Journal of Invasive Cardiology
Mineto Kamata, Mumin Hakim, Joseph D Tobias
BACKGROUND: In recent years, there has been a shift in airway management with the use of cuffed endotracheal tubes (ETT) in pediatric patients. While the use of a syringe to deflate the cuff is generally recommended, anecdotal observations suggest that some healthcare practitioners tear off the pilot balloon from ETT to deflate the cuff. This study was conducted to estimate the residual volume in the cuff when the pilot balloon is torn off for deflation. METHOD: The in vitro study was conducted in three phases...
July 2016: International Journal of Pediatric Otorhinolaryngology
Hamid Gholamhosseini, Andries Meintjes, Mirza Baig, Maria Linden
The increasing availability of low cost and easy to use personalized medical monitoring devices has opened the door for new and innovative methods of health monitoring to emerge. Cuff-less and continuous methods of measuring blood pressure are particularly attractive as blood pressure is one of the most important measurements of long term cardiovascular health. Current methods of noninvasive blood pressure measurement are based on inflation and deflation of a cuff with some effects on arteries where blood pressure is being measured...
2016: Studies in Health Technology and Informatics
René Robert, Mathieu Vinet, Angéline Jamet, Rémi Coudroy
Remote ischemic preconditioning may attenuate renal injury and protect the kidney during subsequent inflammatory or ischemic stress. However, the mechanism of such a protection is not well understood. The aim of this study was to investigate the impact of remote ischemic preconditioning on renal resistivity index (RRI) in nine healthy volunteers. In six volunteers, four cycles of 4-min inflation of a blood pressure cuff were applied to one upper arm, followed by 4-min reperfusion with the cuff deflated. RRI was determined using Doppler echography during each cuff deflated period...
May 19, 2016: Journal of Nephrology
Diego Orbegozo Cortés, Lokmane Rahmania, Marian Irazabal, Carlos Santacruz, Vito Fontana, Daniel De Backer, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Acute respiratory distress syndrome (ARDS) is associated with vascular endothelial dysfunction. The resultant microvascular reactivity can be assessed non-invasively using near-infrared spectroscopy (NIRS) and a vascular occlusion test (VOT) and changes have been correlated with severity of organ dysfunction and mortality in other critically ill populations. We used NIRS to study the presence of microcirculatory alterations in patients with ARDS. METHODS: We studied 27 healthy volunteers and 32 ARDS patients admitted to our intensive care department...
2016: Respiratory Research
Diliang Chen, Fei Chen, Alan Murray, Dingchang Zheng
BACKGROUND: Accurate blood pressure (BP) measurement depends on the reliability of oscillometric cuff pressure pulses (OscP) and Korotkoff sounds (KorS) for automated oscillometric and manual techniques. It has been widely accepted that respiration is one of the main factors affecting BP measurement. However, little is known about how respiration affects the signals from which BP measurement is obtained. The aim was to quantify the modulation effect of respiration on oscillometric pulses and KorS during clinical BP measurement...
2016: Biomedical Engineering Online
Puneet Kaur Randhawa, Amteshwar Singh Jaggi
Remote ischemic preconditioning is a well reported therapeutic strategy that induces cardioprotective effects but the underlying intracellular mechanisms have not been widely explored. The current study was designed to investigate the involvement of TRP and especially TRPV channels in remote hind limb preconditioning-induced cardioprotection. Remote hind limb preconditioning stimulus (4 alternate cycles of inflation and deflation of 5 min each) was delivered using a blood pressure cuff tied on the hind limb of the anesthetized rat...
August 2016: Naunyn-Schmiedeberg's Archives of Pharmacology
Lakesh K Anand, Nitika Goel, Manpreet Singh, Dheeraj Kapoor
OBJECTIVE: The single-use LMA Supreme (Teleflex, Inc., Wayne, PA, USA) and the LMA ProSeal (Teleflex, Inc., Wayne, PA, USA) laryngeal mask airway (LMA) have similar characteristics. To date, studies have not achieved a consensus regarding the oropharyngeal leak pressure (OLP) of the LMA Supreme and LMA ProSeal, and there is little information on their efficacy in laparoscopic cholecystectomy. This study compared the safety and efficacy of the LMA Supreme and LMA ProSeal devices in patients undergoing laparoscopic cholecystectomy...
June 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Baljeet Singh, Puneet Kaur Randhawa, Nirmal Singh, Amteshwar Singh Jaggi
The cardioprotective effects of remote hind limb preconditioning (RIPC) are well established, but its mechanisms still remain to be explored. Therefore, the present study was aimed to explore the possible involvement of 5-lipoxygenase-derived leukotrienes in RIPC. The hind limb was tied by a pressure cuff and was subjected to four episodes of inflation and deflation (5min each) to induce remote hind-limb preconditioning. Thereafter, the hearts were isolated and were subjected to global ischemia (30min) followed by reperfusion (120min) on the Langendorff apparatus...
May 1, 2016: Life Sciences
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