Differences in residual volume above different tracheostomy tube cuffs depending on tube structure, tube tilt angle, and liquid viscosity.

Autor: Katsuno T; Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan., Ueha R; Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan. uehar-oto@h.u-tokyo.ac.jp.; Swallowing Center, The University of Tokyo Hospital, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan. uehar-oto@h.u-tokyo.ac.jp., Fujisaki A; Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan., Unno T; Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan., Cotaoco C; Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan.; Ear Nose Throat Head and Neck Surgery Institute, The Medical City, Pasig, Philippines., Kaneoka A; Swallowing Center, The University of Tokyo Hospital, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan.; Rehabilitation Center, The University of Tokyo Hospital, Tokyo, Japan., Koyama M; Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan., Sato T; Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan., Goto T; Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan., Kondo K; Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2024 Jan; Vol. 281 (1), pp. 311-317. Date of Electronic Publication: 2023 Oct 16.
DOI: 10.1007/s00405-023-08281-6
Abstrakt: Introduction: Proper management of aspirated material above the tracheostomy tube cuff is crucial to prevent complications, such as aspiration pneumonia. This study aimed to thoroughly examine the effects of aspirated liquid viscosity, suction port positioning, and tube tilt angle on residual volume above the cuff (RVAC).
Methods: Five types of tracheostomy tubes (approximately 9 mm outer diameter) were placed through a transparent cylinder with an inner diameter of 18 mm. The cuff was inflated to completely seal the interior of the cylinder. Four liquids with different viscosities were poured onto the cuff, and the liquid above the cuff was suctioned from the side port. The cylinder was angled at 90° and 20°, and each test was performed thrice to determine the average RVAC.
Results: After side-port suctioning, some liquid residue was observed on the cuff of all tracheostomy tubes. The RVAC increased with higher liquid viscosity. The tubes with a longer distance from the suction port opening to the cuff top exhibited more RVAC. Moreover, the RVAC was almost the same regardless of the cylinder angle for tubes with a suction port on the lateral side. However, tubes with backside ports showed a decreased RVAC with cylinder tilt.
Conclusions: This study underscores the persistence of residual material on cuffed tracheostomy tubes even with regular subglottic secretion drainage. This emphasizes the need for specialized tracheostomy tube development aimed at reducing post-suction RVAC. Improved designs can potentially minimize complications associated with residue accumulation.
(© 2023. The Author(s).)
Databáze: MEDLINE
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