Articles: intubation.
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The efficacy of hourly endotracheal tube cuff deflations in minimizing tracheal damage has not been clearly established. Two investigations which specifically address this question arrive at differing conclusions. These investigations fail to report important variables which may have explained the difference in their results. ⋯ Three groups of dogs received either continuous cuff inflation, hourly 5 minute cuff deflations, or a continuous air leak. The air leak group had significanlty less damage than the continuous inflation group (P less than 0.05) and the hourly deflation group (P less than 0.01). There was no significant difference between the continuous inflation group and the 5 minute hourly deflation group.
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Aspiration has been suggested as a source of pulmonary complications seen in patients with tracheal intubation. A previous study demonstrated that the high incidence of aspiration in patients with tracheostomies can be decreased by modification of the tracheostomy tube cuff design. In the present protocol, 100 patients with endotracheal tubes in place were studied to document the incidence of aspiration and to attempt to decrease the incidence by modification of cuff design. ⋯ In 17 patients with modified standard cuffed tubes, the incidence of aspiration was decreased to 29% (5 patients). Aspiration was further decreased to 20% (7 patients) in the 35 patients with high volume, low pressure cuffed tubes. These results demonstrate that the incidence of aspiration in patients with endotracheal tubes can be decreased by modification of endotracheal tube cuff design.