Flovent Inhaler

When used properly, these large cuffs sealed the trachea by draping themselves freely along the contours of the tracheal wall without altering the normal “C” 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.