Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942004000300007
Brazilian Journal of Anesthesiology
Scientific Article

Determinação de volumes e pressões de balonetes de tubos traqueais insuflados com ar ambiente ou óxido nitroso

Volume and pressure of tracheal tube cuffs filled with air or nitrous oxide

Ernesto Leonardo Cárpio Peña; Waldemar Montoya de Gregori; Luiz Piccinini Filho; Joaquim Edson Vieira; Lígia Andrade da Silva Telles Mathias

http://dx.doi.org/10.1590/S0034-70942004000300007 Braz J Anesthesiol, vol.54, n3, p.335-342, 2004
PDF Português
PDF English
Downloads: 0
Views: 982

Resumo

JUSTIFICATIVA E OBJETIVOS: A pressão exercida pelo balonete do tubo traqueal contra a parede da traquéia deve permitir fluxo capilar adequado e prevenir escapes de ar ou aspiração pulmonar. Esta pesquisa procurou determinar as variações de pressão do balonete insuflado com ar ambiente ou com óxido nitroso a 100%. MÉTODO: Trinta pacientes foram selecionados para receber anestesia geral balanceada com intubação orotraqueal. O balonete foi insuflado conforme critérios clínicos. As medidas de base foram realizadas após 15 minutos do início da anestesia com um manômetro aneróide calibrado em cm de H2O e forneceram os valores iniciais de pressão e volume. Os pacientes foram divididos em dois grupos: balonete reinsuflado com ar ambiente, grupo A, ou com óxido nitroso, grupo B. As medidas de pressão foram obtidas em intervalos até a primeira hora e os resultados comparados. RESULTADOS: Os grupos mostraram-se comparáveis para idade e sexo. Em ambos os grupos os valores basais médios para pressão foram próximos de 40 cmH2O com 8 ml de volume. No grupo com ar ambiente, as pressões aumentaram até 36 cmH2O em uma hora. No grupo de balonete insuflado com N2O, as pressões diminuíram abaixo de 20 cmH2O entre 20 e 30 minutos de anestesia. CONCLUSÕES: O uso de N2O a 100% para insuflação do balonete de sonda traqueal não constitui método seguro, acarretando progressiva perda da capacidade de vedação. O uso de ar ambiente promove aumento de volume e de pressão no balonete, aumentando possibilidade de lesão da mucosa traqueal.

Palavras-chave

ANESTÉSICOS, ANESTÉSICOS, EQUIPAMENTOS, INTUBAÇÃO TRAQUEAL, TÉCNICAS DE MEDIÇÃO

Abstract

BACKGROUND AND OBJECTIVES: Tracheal tube cuff pressure against tracheal wall should to prevent air leaked or pulmonary aspiration, allowing adequate capillary blood flow. This study aimed at determining pressure variations of tracheal tube cuffs filled with air or 100% nitrous oxide. METHODS: Participated in this study 30 patients submitted to balanced general anesthesia with tracheal intubation. Cuff was inflated according to clinical criteria. The intracuff pressure measurements were undertaken after 15 minutes of anesthesia by means of an aneroid manometer gaged in cm of H2O and have provided initial pressure and volume values. The patients was allocated in two groups: cuff inflated with air, group A, and with nitrous oxide, group B. Measurements were recorded during one hour and results were compared. Groups were homogeneous in gender and age. RESULTS: Both groups have shown baseline pressure values close to 40 cmH2O with 8 ml of volume. Group filled with air had pressures increased up to 36 cmH2O in one hour. Group filled with nitrous oxide had pressures decreased below 20 cmH2O after 20 to 30 minutes of anesthesia. CONCLUSIONS: 100% nitrous oxide to fill tracheal tube cuffs is not a safe method resulting in progressive air leakage. The cuff air promotes volume and pressure increase, with higher chances for tracheal mucosa injury.

Keywords

ANESTHETICS, ANESTHETICS, EQUIPMENTS, MEASUREMENT TECHNIQUES, TRACHEAL INTUBATION

Referencias

Willis BA, Latto IP, Dyson A. Tracheal tube cuff pressure: Clinical use of the cardiff cuff controller. Anesthesia. 1988;43:312-314.

Bernhard WN, Yost L, Turndorf H. Cuffed tracheal tubes: physical and behavioral characteristics. Anesth Analg. 1982;61:36-41.

Nordin U. The trachea and cuff-induced tracheal injury: An experimental study on causative factors and prevention. Acta Otolaryngol. 1977;345(^sSuppl):1-7.

Knowloson GTG, Bassett HGM. The pressures exerted on the trachea by endotracheal inflatable cuffs. Br J Anaesth. 1970;42:834.

Mendes FF, Hintz L, BredemeierNeto F. Volume e pressão do balonete do tubo traqueal para oclusão da traquéia. Rev Bras Anestesiol. 1996;46:103-106.

Dobrin P, Canfield T. Cuffed endotracheal tubes: mucosal pressures and tracheal wall blood flow. Am J Surg. 1977;133:562-568.

Reader JC, Borchgrevink PC, Silevold OM. Tracheal tube cuff pressures. Anesthesia. 1985;40:444-447.

Seegobin RD, Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four volume cuffs. Br Med J. 1984;288:965-968.

Stanley TH, Kawamura R, Graves C. Effects of nitrous oxide on volume and pressure of endotracheal tube cuffs. Anesthesiology. 1974;41:256-262.

Bernhard WN, Yost LC, Turndorf H. Physical characteristics of and rates of nitrous oxide diffusion into tracheal tube cuffs. Anesthesiology. 1978;48:413-417.

Honeybourne D, Costello JC, Barham C. Tracheal damage after endotracheal intubation: comparison of two types of endotracheal tubes. Thorax. 1982;37:500-502.

Mandoe H, Nikolajsen L, Lintrup U. Sore throat after endotracheal intubation. Anesth Analg. 1992;74:897-900.

Navarro LHC, Braz JRC, Pletsch AK. Estudo comparativo das pressões dos balonetes de tubos traqueais contendo ou não válvula reguladora de pressão de Lanz®. Rev Bras Anestesiol. 2001;51:17-27.

Revenas B, Lindholm CE. Pressure and volume changes in tracheal tube cuffs during anesthesia. Acta Anaesthesiol Scand. 1976;20:321-326.

Tu HN, Saidi N, Leiutaud T. Nitrous oxide increases endotracheal cuff pressure and the incidence of tracheal lesions in anesthetized patients. Anesth Analg. 1999;89:187-190.

Karasawa F, Ohshima T, Takamatsu I. The effect on intracuff pressure of various nitrous oxide concentrations used for inflating an endotracheal tube cuff. Anesth Analg. 2000;91:708-713.

Combes X, Schauvliege F, Peyrouset O. Intracuff pressure and tracheal morbidity: influence of filling with saline during nitrous oxide anesthesia. Anesthesiology. 2001;95:1120-1124.

Fagan C, Frizelle HP, Laffey J. The effects of intracuff lidocaine on endotracheal-tube-induced emergence phenomena after general anesthesia. Anesth Analg. 2000;91:201-205.

5dd7e6a30e8825cf6913f286 rba Articles
Links & Downloads
2352-2291 (Electrónico) 0104-0014 (Impreso)
Braz J Anesthesiol ©2024 Todos los derechos reservados.

Braz J Anesthesiol

Share this page
Page Sections