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Pressures exerted by endobronchial devices.

Andrew Roscoe¹, George W Kanellakos, Karen McRae

¹Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario.

Anesthesia and Analgesia

|February 22, 2007

Summary

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A Clinical Comparison of 2 Bronchial Blockers Versus Double-Lumen Tubes for One-Lung Ventilation.

Journal of cardiothoracic and vascular anesthesia·2023

This study measured pressures from double-lumen tube (DLT) and endobronchial blocker (EBB) cuffs. Clinically relevant volumes kept cuff pressures below the 30 mm Hg limit, suggesting reduced risk of airway injury.

Area of Science:

Anesthesiology
Respiratory Medicine
Medical Device Engineering

Background:

High endotracheal cuff pressures can lead to mucosal ischemia.
Direct measurement of bronchial cuff pressures is needed.

Purpose of the Study:

To directly measure pressures exerted by double-lumen tube (DLT) and endobronchial blocker (EBB) cuffs.
To assess if these pressures exceed safe limits for preventing mucosal injury.

Main Methods:

Utilized a validated in vitro model and established technique.
Measured static and dynamic pressures of DLT and EBB cuffs at varying volumes.
Simulated positive pressure ventilation conditions.

Main Results:

DLT cuff pressures ranged from 16-155 mm Hg.

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EBB cuff pressures ranged from 39-194 mm Hg.

At volumes creating a seal for 25 cm H2O positive pressure, all device cuff pressures were <30 mm Hg.

Conclusions:

Pressures exerted by DLT and EBB cuffs at clinically relevant volumes are below the recommended 30 mm Hg limit.
This suggests a reduced risk of mucosal injury with these devices.