Clinical Survey of Appropriate Cuff Volume and Pressure during General Anesthesia in Pediatric Patients / 대한구급학회지

ABSTRACT

BACKGROUND: Uncuffed endotracheal tubes are commonly used in pediatrics even when the risk of gastric aspiration is significant. But cuffed endotracheal tubes effectively protect the risk of pulmonary aspiration and completely seal the airway. This study was designed to determine the appropriate cuff volume and pressure with low risk of ischemic injury to children's airway. METHODS: We intubated cuffed endotracheal tube (internal diameter 4.5, 5.0, 5.5 mm) in 90 surgical pediatric patient from 16 to 118 months of age. After intubation, initial cuff volume and pressure were measured at the level of complete sealing in each group. Each group was administrated 50% nitrous oxide and 67% nitrous oxide and measured cuff pressure at 20 minutes, 40 minutes. RESULTS: 1) The mean initial cuff volume and pressure of 4.5 ID tube were 0.59 +/- 0.16 ml and 14.5 +/- 0.31 cmH2O (n=30). 2) The mean initial cuff volume and pressure of 5.0 ID tube were 1.00 +/- 0.38 ml and 14.3 +/- 3.55 cmH2O (n=30). 3) The mean initial cuff volume and pressure of 5.5 ID tube were 1.06 +/- 0.26 ml and 14.28 +/- 2.01 cmH2O (n=30). 4) The cuff pressure increased significantly in the course of time, but no pressure in three groups was above 30 cmH2O. CONCLUSIONS: We could determine the appropriate cuff volume of cuffed endotracheal tube in pediatric patients. Also we concluded that nitrous oxide concentration affect little intracuff pressure in brief operation.