Flovent Inhaler

- High-volume, Low-pressure Cuffs (1)

High-volume, Low-pressure Cuffs (1)In the 1960s, ischemic tracheal complications such as tracheal stenosis and tracheoesophageal fistula occurred in up to 20 percent of intubated and mechanically ventilated patients. Endotracheal tubes were typically constructed with low-volume cuffs which had little or no resting volume and a diameter smaller than tracheal diameter. Such cuffs frequently required inflation pressures of 160 to 300 mm Hg to seal the trachea and deformed the trachea from its normal ā€œCā€ shape into an expanded circular shape. The pressure exerted upon the tracheal mucosa (CT pressure) by inflating a low-volume, high-pressure cuff was impossible to estimate; however, directly measured CT pressures ranged up to 200 mm Hg or more. Furthermore, small increments (1 to 3 ml) in cuff volume beyond the MOV produced increases in the CT pressure of up to 100 mm Hg or more. Such high CT pressures severely restricted tracheal wall blood flow and caused mucosal ulceration, tracheomalacia with tracheal dilation, perforation and tracheal stenosis as scar formation occurred with healing.
In the early 1970s, large volume cuffs with a diameter greater than that of the trachea largely replaced the low-volume, high-pressure cuffs.

June 8, 2013 Cardiac function
Tags: airway pressure ischemic tracheal complications tracheal stenosis