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Philippe Seguin, Harmonie Perrichet, Estelle Le Pabic, Yoann Launey, Marie Tiercin, Romain Corre, Graziella Brinchault, Bruno Laviolle
Background and Aims: A risk of tracheal mucosa injury induced by subglottic suctioning has been raised. Therefore, this prospective randomized study aims to compare the effect of continuous suctioning of subglottic secretions versus intermittent suctioning of subglottic secretions (CSSS vs. ISSS) secretions on tracheal mucosa in front of the suctioning port of the endotracheal tube. Patients and Methods: Patients requiring intubation or reintubation in Intensive Care Unit with an expected ventilation duration > 24 h were eligible...
January 2018: Indian Journal of Critical Care Medicine
Eunkyung Choi, Yongmin Park, Younghoon Jeon
BACKGROUND: Positional change affects the cuff pressure of an endotracheal tube (ETT) in treacheally intubated patients. We compared the cuff pressure of a TaperGuard ETT and a cylindrical ETT after lateral rotation of head during middle ear surgery. METHODS: Fifty-two patients aged 18-70 years underwent a tympanomastoidectomy under general anesthesia were randomly allocated to receive endotracheal intubation with cylindrical (group C, n = 26) or TaperGuard ETTs (group T, n = 26)...
March 2017: Medicine (Baltimore)
Maryanne Z Mariyaselvam, Lucy L Marsh, Sarah Bamford, Ann Smith, Matt P Wise, David W Williams
BACKGROUND: Aspiration of subglottic secretions past the endotracheal tube (ETT) cuff is a prerequisite for developing ventilator-associated pneumonia (VAP). Subglottic secretion drainage (SSD) ETTs reduce aspiration of subglottic secretions and have demonstrated lower VAP rates. We compared the performance of seven SSD ETTs against a non-SSD ETT in preventing aspiration below inflated cuffs. METHODS: ETTs were positioned vertically in 2 cm diameter cylinders. Four ml of a standard microbial suspension was added above inflated cuffs...
March 4, 2017: BMC Anesthesiology
Ata Mahmoodpoor, Hadi Hamishehkar, Masoud Hamidi, Kamran Shadvar, Sarvin Sanaie, Samad Ej Golzari, Zahid Hussain Khan, Nader D Nader
BACKGROUND: Endotracheal tube placement is necessary for the control of the airway in patients who are mechanically ventilated. However, prolonged duration of endotracheal tube placement contributes to the development of ventilator-associated pneumonias (VAPs). The aim of this study was to evaluate whether subglottic suctioning using TaperGuard EVAC tubes was effective in decreasing the frequency of VAP. METHODS: A total of 276 mechanically ventilated patients for more than 72 hours were randomly assigned to group E (EVAC tube) and group C (conventional tube)...
April 2017: Journal of Critical Care
Christopher T Chenelle, Taiga Itagaki, Daniel F Fisher, Lorenzo Berra, Robert M Kacmarek
BACKGROUND: Cuff design affects microaspiration, a risk factor for pneumonia. We questioned whether the PneuX low-volume fold-free cuff design would prevent cuff leakage and maintain the same tracheal wall pressure as high-volume, low-pressure (HVLP) cuffs. METHODS: We evaluated 4 HVLP-cuffed endotracheal tubes (ETTs), Hi-Lo (polyvinyl chloride [PVC]), Microcuff (polyurethane [PU]), SealGuard (PU + tapered), and TaperGuard (PVC + tapered), and the PneuX with its dedicated tracheal seal monitor...
January 2017: Respiratory Care
Tomohiko Kimijima, Mitsutaka Edanaga, Michiaki Yamakage
The objective of this study was to compare fluid leakage across endotracheal tube cuffs using a three-dimensional (3D)-printed human tracheal model that anatomically simulates the human trachea. We made two models based on computed tomography data of the neck and chest. Using a Mallinckrodt Hi-Lo™ (HL), ThinCuff(®) (TC), and Mallinckrodt TaperGuard™ (TG), we sequentially measured the amount of fluid leakage across each endotracheal tube cuff after applying saline or viscous liquid above the cuff. The TG allowed significantly less leakage than the HL and TC with both saline and the viscous liquid...
June 2016: Journal of Anesthesia
Yu Miyazaki, Nobuyasu Komasawa, Ryosuke Mihara, Yosuke Kuzukawa, Shiho Deguchi, Toshiaki Minami
BACKGROUND: The purpose of this study was to compare the upper gastrointestinal endoscope (UGE) insertion-mediated cuff pressure increase between a tracheal tube with a tapered cuff (Taper) and or conventional high volume low pressure cuff (HVLP) utilizing a porcine larynx model. METHODS: The automated cuff pressure was adjusted to 10, 20, and 30 cmH2O. The Taper and HVLP cuff pressure increases by UGE insertion were measured. RESULTS: Significant cuff pressure increase was observed by UGE insertion regardless of initial cuff pressure...
March 2015: Masui. the Japanese Journal of Anesthesiology
Seamus Maguire, Frances Haury, Korinne Jew
INTRODUCTION: The Shiley™ Flexible adult tracheostomy tube with TaperGuard™ cuff has been designed through its geometry, materials, diameter, and wall thickness to minimize micro-aspiration of fluids past the cuff and to provide an effective air seal in the trachea while also minimizing the risk of excessive contact pressure on the tracheal mucosa. The cuff also has a deflated profile that may allow for easier insertion through the stoma site. This unique design is known as the TaperGuard™ cuff...
2015: Medical Devices: Evidence and Research
Sarah K Rozycki, Fredrick P Dixon, Melissa A Yopp, Norma J Maxvold, Bruce K Rubin
BACKGROUND: Endotracheal tube (ETT) cuffs create a seal to protect against secretion entry to the lungs. Cuff inflation currently is recommended at 20-30 cm H2O pressure. ETT designs have variable seal performance in bench studies using rigid tracheal models lacking the dynamic characteristics of the human trachea. We compared ETT designs within a new, biorealistic tracheal model to assess cuff and suction performance in the setting of a compliant trachea. METHODS: Three ETT designs (Mallinckrodt Hi-Lo, KimVent Microcuff, and Sheridan/HVT) were tested for performance by simulant leakage below the cuff and air leakage (measured as return tidal volume ≥ 80% delivered) over a range of cuff (5-25 cm H2O) and end-expiratory pressure (PEEP 0-15 cm H2O)...
August 2015: Respiratory Care
Hyun-Chang Kim, Yong-Hun Lee, Eugene Kim, Eun-Ah Oh, Young-Tae Jeon, Hee-Pyoung Park
PURPOSE: Positional change can displace an endotracheal tube (ETT) and change the ETT cuff pressure in a tracheally intubated patient. Endotracheal tubes with different cuff shapes may lead to different cuff pressures after positional change. We hypothesized that the intracuff pressure in the TaperGuard™ ETT with a tapered-shaped cuff would be higher than that in the conventional ETT with a cylindrical-shaped cuff after a change from the supine to the lateral flank position. METHODS: Fifty-eight patients scheduled for open urological procedures in the lateral flank position were randomly allocated to receive either a TaperGuard ETT (group T) or conventional ETT (group C)...
October 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Yu Miyazaki, Nobuyasu Komasawa, Haruka Omoto, Shinichiro Miyazaki, Haruki Kido, Toshiaki Minami
We report the successful awake tracheal intubation in a patient with hypopharyngeal cancer and gastroesophageal regurgitation with the TaperGuard Evac tracheal tube (TaperGuard) and Pentax-AWS Airwayscope (AWS). A 63-year-old man with hypopharyngeal cancer with invasion to the glottis was scheduled for total laryngectomy under general anesthesia. He had undergone thoracic esophagectomy and could not maintain supine position due to severe gastroesophageal regurgitation. To avoid vomiting after induction of anesthesia, we planned awake intubation in the sitting position with the AWS...
June 2014: Masui. the Japanese Journal of Anesthesiology
Sayuri Matsunami, Nobuyasu Komasawa, Shunsuke Fujiwara, Kenta Nakao, Shinichi Tatsumi, Toshiaki Minami
BACKGROUND: Microaspiration of vomitus can cause a serious condition known as Mendelson's syndrome. The present study used simulated stomach contents and an airway model to compare a tracheal tube with a tapered cuff (Taper) to the conventional high volume low pressure cuff (HVLP) in their abilities to prevent microaspiration. METHODS: The automated cuff pressure was adjusted to 10, 20, and 30 cmH2O. We poured 5 ml of simulated stomach contents above the cuff in the vertically situated airway model and measured the leakage volume after 5 minutes as well as 4 hours...
May 2014: Masui. the Japanese Journal of Anesthesiology
Ewelina Gaszyńska, Paweł Ratajczyk, Andrzej Wieczorek, Tomasz Szewczyk, Tomasz Gaszyński
UNLABELLED: Tracheal secretion leakage might lead to ventilator-associated pneumonia. Standard tracheal tube cuffs are cylindrical in shape. Bronchial tree aspiration is observed in the presence of leakage past tracheal tube cuffs. The new TaperGuard tracheal tube has a cuff in the shape of a cone, preventing from the development of microtubules and microaspiration. The aim of the study was to compare standard tracheal tube cuffs with TaperGuard tubes, in terms of protection from microaspiration under general anesthesia...
March 2014: Polski Przeglad Chirurgiczny
Ata Mahmoodpoor, Ali Peyrovi-far, Hadi Hamishehkar, Zhaleh Bakhtyiari, Mir Mousa Mirinezhad, Masoud Hamidi, Samad Eslam Jamal Golzari
Because microaspiration of contaminated supraglottic secretions past the endotracheal tube cuff is considered to be central in the pathogenesis of pneumonia, improved design of tracheal tubes with new cuff material and shape have reduced the size and number of folds, which together with the addition of suction ports above the cuff to drain pooled subglottic secretions leads to reduced aspiration of oropharyngeal secretions. So we conducted a study to compare the prophylactic effects of polyurethane-cylindrical or tapered cuff and polyvinyl chloride cuff endotracheal tubes (ETT) on ventilator-associated pneumonia...
2013: Acta Medica Iranica
Arthur C W Lau, S M Lam, W W Yan
OBJECTIVES. To compare three endotracheal tubes for leakage across the cuff (microaspiration) under a comprehensive set of simulated clinical situations. These were the Mallinckrodt TaperGuard (Covidien, US) with a tapered polyvinyl chloride cuff; the KimVent Microcuff (Kimberly-Clark Health Care, US) with a cylindrical polyurethane cuff; and a conventional Portex (Smiths Medical International Ltd, UK) with a globular polyvinyl chloride cuff. DESIGN. A benchtop experimental study. SETTING AND MATERIALS. A silicone cylinder serving as the model trachea was intubated with each of the three endotracheal tubes, one at a time...
February 2014: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
E Suys, K Nieboer, W Stiers, J De Regt, L Huyghens, H Spapen
OBJECTIVE: Injurious prolapse of tracheal mucosa into the suction port has been reported in up to 50% of intubated patients receiving continuous aspiration of subglottic secretions. We investigated whether similar injury could be inflicted by automated intermittent aspiration. METHODS: Six consecutive patients, intubated with the Mallinckrodt TaperGuard Evac™ endotracheal tube, were studied. A flow sensor was placed between the vacuum regulating system and the mucus collector...
December 2013: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
J Y Hwang, S H Han, S H Park, S J Park, S Park, S H Oh, J H Kim
BACKGROUND: Current tracheal tubes (TTs) cannot guarantee a perfect seal against pulmonary aspiration of upper airway secretions. The purpose of this study was to investigate whether a gel layer between the tracheal tube with double cuffs (Double cuffs) prevents fluid leakage past TT cuffs. METHODS: In vitro fluid leakage tests were performed using the Double cuff with or without a gel layer between the two cuffs and four commercially available TTs (Euromedical Standard TT, Mallinckrodt Hi-Lo™, Microcuff, and Mallinckrodt TaperGuard™) when placed in artificial tracheas with three-different internal diameters (ID; 16, 20, and 22 mm)...
September 2013: British Journal of Anaesthesia
J Shiotsuka, A T Lefor, M Sanui, O Nagata, A Horiguchi, Y Sasabuchi
INTRODUCTION: This study was designed to quantitatively evaluate the sealing effect of a polyvinyl chloride tapered endotracheal tube cuff and to compare the tapered cuff with cylindrical endotracheal tube cuffs using an in vitro viscous fluid model. METHODS: Five types of 8.0 mm inner diameter endotracheal tubes (TaperGuard, PortexSacett, PortexSoftseal, Sheridan HVT, Sheridan CF) were fixed in vertically placed 20mm internal diameter acrylic tubes. The cuffs were inflated to 25 mmHg pressure and water was added to the top of the cuff...
2012: HSR Proceedings in Intensive Care & Cardiovascular Anesthesia
David L Bowton, R Duncan Hite, R Shayn Martin, Robert Sherertz
BACKGROUND: Aspiration of colonized oropharyngeal secretions is a major factor in the pathogenesis of ventilator-associated pneumonia (VAP). A tapered-cuff endotracheal tube (ETT) has been demonstrated to reduce aspiration around the cuff. Whether these properties are efficacious in reducing VAP is not known. METHODS: This 2-period, investigator-initiated observational study was designed to assess the efficacy of a tapered-cuff ETT to reduce the VAP rate. All intubated, mechanically ventilated patients over the age of 18 were included...
October 2013: Respiratory Care
Sayaka Tsuboi, Tetsuya Miyashita, Yoshikazu Yamaguchi, Yoshiko Yamamoto, Kentaro Sakamaki, Takahisa Goto
BACKGROUND: Studies have compared sealing effects of the newly developed tapered endotracheal tube cuff with the conventional cylindrical cuff. In this study, we compared the difference between cuffs with regard to the increase in intracuff pressure during nitrous oxide (N(2)O) exposure. METHODS: Two types of cuffs were studied using a model trachea connected to a mechanical test lung: high-volume, low-pressure cuff (Mallinckrodt Hi-Lo(TM), Covidien, Dublin, Ireland) and tapered cuff (Mallinckrodt TaperGuardTM, Covidien)...
March 2013: Anesthesia and Analgesia
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