University of Michigan Medical School, Michigan Medicine, University of Michigan, 1301 Catherine Street, Ann Arbor, MI 49109, USA; Department of Otolaryngology - Head and Neck Surgery, Wayne State University, 5E UHC, 4201 St Antoine, Detroit, MI 48201, USA.
Department of Mechanical Engineering, College of Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109, USA; Department of Biomedical Engineering, College of Engineering, University of Michigan, 2200 Bonisteel Boulevard, Ann Arbor, MI 48109, USA.
Am J Otolaryngol. 2024 Jul-Aug;45(4):104366. doi: 10.1016/j.amjoto.2024.104366. Epub 2024 Apr 29.
This study investigated dimension changes of various nasopharyngeal airways, including a novel self-supporting device, after saline submersion at body temperature to simulate in-vivo use. Dimension changes over time may reduce efficacy during long-term use and require sizing adjustments or limits on duration of use.
Cuffless Covidien endotracheal tubes, pediatric Rusch fixed flange polyvinyl chloride nasal airway tubes, pediatric Rusch Robertazzi style Mediprene nasal airway tubes, and novel silicone elastomer self-supporting nasopharyngeal airways were fully submerged in 0.9 % normal saline solution incubated at 37 degrees Celsius for 15 days. All devices had tube length and wall thickness measured after 0, 1, 2, 3, 4, 5, 10, and 15 days. The 95 % confidence intervals of tube dimensions at each date were compared with the 95 % confidence intervals at day 0.
The Covidien ET tube, Rusch PVC NPA, and ssNPA tube lengths and wall thicknesses did not change significantly over 15 days. The Rusch Mediprene NPAs had a statistically significant increase in length starting at day 1 and wall thickness at day 2.
The novel ssNPA did not expand in the in-vitro environment, supporting its safety for extended use. The PVC NPA and ET tube dimensions also remained stable. However, the Rusch Mediprene NPAs had significant length expansion after 1 day of submersion, indicating a considerable risk of expansion during extended use with potential implications for patient care. Silicone and PVC NPA dimensions remained stable when saturated, indicating these materials may be more appropriate for extended use.
本研究通过在体温下将生理盐水浸入各种鼻咽气道，包括新型自支撑装置，以模拟体内使用情况，研究其尺寸变化。随着时间的推移，尺寸变化可能会降低长期使用的效果，需要进行尺寸调整或限制使用时间。
将无囊 Covidien 气管内管、小儿 Rusch 固定凸缘聚氯乙烯鼻气道管、小儿 Rusch Robertazzi 式 Mediprene 鼻气道管和新型硅酮弹性体自支撑鼻咽气道完全浸入 0.9%生理盐水溶液中，在 37°C 下孵育 15 天。所有装置在 0、1、2、3、4、5、10 和 15 天后测量管长和管壁厚度。在每个日期的管尺寸的 95%置信区间与第 0 天的 95%置信区间进行比较。
Covidien ET 管、Rusch PVC NPA 和 ssNPA 管的长度和管壁厚度在 15 天内没有明显变化。Rusch Mediprene NPAs 的长度从第 1 天开始和管壁厚度从第 2 天开始有统计学意义上的增加。
新型 ssNPA 在体外环境中没有扩张，支持其延长使用的安全性。PVC NPA 和 ET 管尺寸也保持稳定。然而，Rusch Mediprene NPAs 在浸入 1 天后长度显著扩张，表明在延长使用期间扩张风险相当大，可能对患者护理产生影响。当饱和时，硅酮和 PVC NPA 尺寸保持稳定，表明这些材料可能更适合延长使用。
