The effects of extubation with an inflated versus deflated endotracheal tube cuff on endotracheal fluid volume in the dog
Farmer, Amanda Rose
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An endotracheal tube (ETT) is frequently used for airway management during anesthesia, and proper inflation of the ETT cuff is critical for patient safety. Pressure of the cuff must be high enough to seal the trachea to prevent aspiration, yet low enough to avoid damaging the airway. During extubation, the ETT cuff is routinely deflated before removal to minimize trauma to the trachea and larynx. However, if there is concern about fluid remaining in the trachea, the ETT is sometimes extubated with the cuff inflated or partially inflated. Presently, there is little information regarding the potential benefits of extubation with an inflated ETT cuff. The purpose of this study was to investigate the effective protection against liquid aspiration in canines provided by the removal of inflated and deflated ETT cuffs. Sixteen female beagle cadavers were orotracheally intubated in lateral recumbency, and the ETT cuffs were inflated to a closing pressure of 20 cm H2O before barium was introduced orad to the cuff. The dogs were randomly assigned to an ETT cuff extubation condition of deflated or unchanged from the original closing pressure. After extubation, the cadavers were x-rayed, and the radiographs were assessed to determine the amount of barium remaining in the trachea. It was determined that the dogs in the deflated ETT cuff group had an average of 0.9 mL more residual intratracheal contrast than dogs extubated with an inflated ETT cuff. Therefore, extubation with the cuff inflated will remove contents and will most likely prevent aspiration.