Brimacombe Joseph, Keller Christian, Roth Winfried, Loeckinger Alex
Department of Anaesthesia and Intensive Care Medicine, Cairns Base Hospital, The Esplanade, Cairns 4870, Australia.
Can J Anaesth. 2002 Dec;49(10):1084-7. doi: 10.1007/BF03017908.
The laryngeal tube airway (LTA) is a new extraglottic airway device with a large proximal cuff that inflates in the laryngopharynx and a distal conical cuff that inflates in the hypopharynx. We determine the influence of the cuff volume and anatomic location on pharyngeal mucosal pressures for the LTA.
Fifteen fresh cadavers were studied. Microchip sensors were attached to the (anatomic location) anterior, lateral and posterior surface of the distal cuff (hypopharynx) and proximal cuff (laryngopharynx) of the size 4 LTA. Oropharyngeal leak pressure (OLP) and mucosal pressures were measured at 0-140 mL cuff volume in 20-mL increments. In addition, mucosal pressures for the proximal cuff were measured in three awake, topicalized volunteers.
OLP and mucosal pressure at all locations increased with cuff volume (all: P < 0.01). Mucosal pressures were highest posteriorly. Mucosal pressures only exceeded 35 cm H(2)O (pharyngeal mucosal perfusion pressure) in the anterior and posterior laryngopharynx and when the cuff volume was > 80-100 mL. Mucosal pressures were similar for cadavers and awake volunteers.
Mucosal pressures for the LTA increase with cuff volume, are highest posteriorly and potentially exceed mucosal perfusion pressure when cuff volume exceeds 80-100 mL.
喉罩气道（LTA）是一种新型声门上气道装置，其近端有一个可在喉咽部充气的大袖带，远端有一个可在下咽部充气的锥形袖带。我们确定了袖带容积和解剖位置对LTA咽部黏膜压力的影响。
对15具新鲜尸体进行研究。将微芯片传感器附着于4号LTA远端袖带（下咽）和近端袖带（喉咽）的（解剖位置）前、侧和后表面。以20 mL为增量，在袖带容积为0 - 140 mL时测量口咽漏气压（OLP）和黏膜压力。此外，还在3名清醒、局部麻醉的志愿者中测量了近端袖带的黏膜压力。
所有位置的OLP和黏膜压力均随袖带容积增加而升高（均为：P < 0.01）。黏膜压力在后部最高。仅在喉咽前部和后部，以及袖带容积> 80 - 100 mL时，黏膜压力才超过35 cm H₂O（咽部黏膜灌注压）。尸体和清醒志愿者的黏膜压力相似。
LTA的黏膜压力随袖带容积增加而升高，在后部最高，当袖带容积超过80 - 100 mL时可能超过黏膜灌注压。
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