Dobrin P, Canfield T
Am J Surg. 1977 May;133(5):562-8. doi: 10.1016/0002-9610(77)90008-3.
Eighteen brands of cuffed endotracheal tubes, including those with the new low pressure cuffs, were evaluated and compared. Experiments were performed in vitro on excised dog tracheae to measure the mucosal pressure exerted by the inflated cuffs. Pressure was measured directly with a mechanical sensor. Latex cuffs exerted the highest mucosal pressures, whereas silicone cuffs exerted the lowest mucosal pressures. Polyvinyl chloride cuffs exerted intermediate levels of mucosal pressure. With each material, predistended cuffs exerted lower mucosal pressures than nonpredistended cuffs. A second set of experiments was performed in vivo to determine the effect of mucosal pressure on tracheal wall blood flow. These studies employed a thermistor technic. The data showed that, when inflated sufficiently to seal within the trachea, stiff cuffs reduced blood flow more than compliant cuffs. With all cuffs, blood flow was reduced more at the mucosa than at deeper regions of the tracheal wall.It was concluded that for clinical use, compliant cuffs are preferable to stiff cuffs because they should cause less ischemia.
对18种带套囊气管内导管品牌进行了评估和比较，包括那些带有新型低压套囊的导管。在体外对切除的犬气管进行实验，以测量充气套囊施加的粘膜压力。使用机械传感器直接测量压力。乳胶套囊施加的粘膜压力最高，而硅胶套囊施加的粘膜压力最低。聚氯乙烯套囊施加的粘膜压力处于中间水平。对于每种材料，预扩张的套囊比未预扩张的套囊施加的粘膜压力更低。进行了第二组体内实验，以确定粘膜压力对气管壁血流的影响。这些研究采用了热敏电阻技术。数据表明，当充分充气以在气管内密封时，硬质套囊比顺应性套囊对血流的减少作用更大。对于所有套囊，粘膜处的血流减少比气管壁深层区域更多。得出的结论是，对于临床应用，顺应性套囊比硬质套囊更可取，因为它们应该引起更少的局部缺血。
