Flovent Inhaler

- High-volume, Low-pressure Cuffs (2)

When used properly, these large cuffs sealed the trachea by draping themselves freely along the contours of the tracheal wall without altering the normal ā€œCā€ shape of the trachea. As a result, these cuffs did not need to be inflated beyond their resting diameter and required lower inflation pressures than the earlier low-volume, high-pressure design. Furthermore, cuff inflation pressures approximately equalled CT pressure because no pressure was generated by stretching the cuff to fill the trachea. Thus, the high-volume, low-pressure design operated with less CT pressure and reduced the overall incidence of ischemic tracheal complications.
In 1981, Stauffer et al reported findings in a group of 150 patients who were mechanically ventilated with tracheal intubation in a SICU. Despite the use of high-volume, low-pressure endotracheal cuffs, at follow-up 11 percent (3 of 27) had tomographic evidence of tracheal stenosis at the cuff site, an incidence strikingly similar to previous reports involving low-volume, high-pressure cuffs. They also found that 19 percent of the 150 SICU patients required excessive cuff pressure (>25 mm Hg) to seal the trachea, while an inability to seal the airway was noted in 11 percent despite intracuff pressures up to 60 mm Hg.

June 9, 2013 Cardiac function
Tags: airway pressure ischemic tracheal complications tracheal stenosis