An in vitro comparison of tracheostomy tube cuffs

Seamus Maguire,1 Frances Haury,2 Korinne Jew2 1Research and Development, Covidien Respiratory and Monitoring Solutions, Athlone, Ireland; 2Medical Affairs, Covidien Respiratory and Monitoring Solutions, Boulder, CO, USA Introduction: The Shiley™ Flexible adult tracheostomy tube with TaperG...

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Autores principales:	Maguire S, Haury F, Jew K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/2dac783b945b4a888cee4a31a877c504
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spelling	oai:doaj.org-article:2dac783b945b4a888cee4a31a877c5042021-12-02T05:07:17ZAn in vitro comparison of tracheostomy tube cuffs1179-1470https://doaj.org/article/2dac783b945b4a888cee4a31a877c5042015-04-01T00:00:00Zhttp://www.dovepress.com/an-in-vitro-comparison-of-tracheostomy-tube-cuffs-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Seamus Maguire,1 Frances Haury,2 Korinne Jew2 1Research and Development, Covidien Respiratory and Monitoring Solutions, Athlone, Ireland; 2Medical Affairs, Covidien Respiratory and Monitoring Solutions, Boulder, CO, USA Introduction: The Shiley™ Flexible adult tracheostomy tube with TaperGuard™ cuff has been designed through its geometry, materials, diameter, and wall thickness to minimize micro-aspiration of fluids past the cuff and to provide an effective air seal in the trachea while also minimizing the risk of excessive contact pressure on the tracheal mucosa. The cuff also has a deflated profile that may allow for easier insertion through the stoma site. This unique design is known as the TaperGuard™ cuff. The purpose of the observational, in vitro study reported here was to compare the TaperGuard™ taper-shaped cuff to a conventional high-volume low-pressure cylindrical-shaped cuff (Shiley™ Disposable Inner Cannula Tracheostomy Tube [DCT]) with respect to applied tracheal wall pressure, air and fluid sealing efficacy, and insertion force.Methods: Three sizes of tracheostomy tubes with the two cuff types were placed in appropriately sized tracheal models and lateral wall pressure was measured via pressure-sensing elements on the inner surface. Fluid sealing performance was assessed by inflating the cuffs within the tracheal models (25 cmH2O), instilling water above the cuff, and measuring fluid leakage past the cuff. To measure air leak, tubes were attached to a test lung and ventilator, and leak was calculated by subtracting the average exhaled tidal volume from the average delivered tidal volume. A tensile test machine was used to measure insertion force for each tube with the cuff deflated to simulate clinical insertion through a stoma site.Results: The average pressure exerted on the lateral wall of the model trachea was lower for the taper-shaped cuff than for the cylindrical cuff under all test conditions (P<0.05). The taper-shaped cuff also demonstrated a more even, lower pressure distribution along the lateral wall of the model trachea. The average air and fluid seal performance with the taper-shaped cuff was significantly improved, when compared to the cylindrical-shaped cuff, for each tube size tested (P<0.05). The insertion force for the taper-shaped cuff was ~40% less than that for the cylindrical-shaped cuff.Conclusion: In a model trachea, the Shiley™ Flexible Adult tracheostomy tube with TaperGuard™ cuff, when compared to the Shiley™ Disposable Inner Cannula Tracheostomy tube with cylindrical cuff, exerted a lower average lateral wall pressure and a more evenly distributed pressure. In addition, it provided more effective fluid and air seals and required less force to insert.Keywords: airway device, air seal, fluid seal, taper-shaped cuff, intra-cuff pressure, cuff pressureMaguire SHaury FJew KDove Medical PressarticleMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2015, Iss default, Pp 185-192 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical technology R855-855.5
spellingShingle	Medical technology R855-855.5 Maguire S Haury F Jew K An in vitro comparison of tracheostomy tube cuffs
description	Seamus Maguire,1 Frances Haury,2 Korinne Jew2 1Research and Development, Covidien Respiratory and Monitoring Solutions, Athlone, Ireland; 2Medical Affairs, Covidien Respiratory and Monitoring Solutions, Boulder, CO, USA Introduction: The Shiley™ Flexible adult tracheostomy tube with TaperGuard™ cuff has been designed through its geometry, materials, diameter, and wall thickness to minimize micro-aspiration of fluids past the cuff and to provide an effective air seal in the trachea while also minimizing the risk of excessive contact pressure on the tracheal mucosa. The cuff also has a deflated profile that may allow for easier insertion through the stoma site. This unique design is known as the TaperGuard™ cuff. The purpose of the observational, in vitro study reported here was to compare the TaperGuard™ taper-shaped cuff to a conventional high-volume low-pressure cylindrical-shaped cuff (Shiley™ Disposable Inner Cannula Tracheostomy Tube [DCT]) with respect to applied tracheal wall pressure, air and fluid sealing efficacy, and insertion force.Methods: Three sizes of tracheostomy tubes with the two cuff types were placed in appropriately sized tracheal models and lateral wall pressure was measured via pressure-sensing elements on the inner surface. Fluid sealing performance was assessed by inflating the cuffs within the tracheal models (25 cmH2O), instilling water above the cuff, and measuring fluid leakage past the cuff. To measure air leak, tubes were attached to a test lung and ventilator, and leak was calculated by subtracting the average exhaled tidal volume from the average delivered tidal volume. A tensile test machine was used to measure insertion force for each tube with the cuff deflated to simulate clinical insertion through a stoma site.Results: The average pressure exerted on the lateral wall of the model trachea was lower for the taper-shaped cuff than for the cylindrical cuff under all test conditions (P<0.05). The taper-shaped cuff also demonstrated a more even, lower pressure distribution along the lateral wall of the model trachea. The average air and fluid seal performance with the taper-shaped cuff was significantly improved, when compared to the cylindrical-shaped cuff, for each tube size tested (P<0.05). The insertion force for the taper-shaped cuff was ~40% less than that for the cylindrical-shaped cuff.Conclusion: In a model trachea, the Shiley™ Flexible Adult tracheostomy tube with TaperGuard™ cuff, when compared to the Shiley™ Disposable Inner Cannula Tracheostomy tube with cylindrical cuff, exerted a lower average lateral wall pressure and a more evenly distributed pressure. In addition, it provided more effective fluid and air seals and required less force to insert.Keywords: airway device, air seal, fluid seal, taper-shaped cuff, intra-cuff pressure, cuff pressure
format	article
author	Maguire S Haury F Jew K
author_facet	Maguire S Haury F Jew K
author_sort	Maguire S
title	An in vitro comparison of tracheostomy tube cuffs
title_short	An in vitro comparison of tracheostomy tube cuffs
title_full	An in vitro comparison of tracheostomy tube cuffs
title_fullStr	An in vitro comparison of tracheostomy tube cuffs
title_full_unstemmed	An in vitro comparison of tracheostomy tube cuffs
title_sort	in vitro comparison of tracheostomy tube cuffs
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/2dac783b945b4a888cee4a31a877c504
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An in vitro comparison of tracheostomy tube cuffs

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