Endotracheal Tube Cuff Residual Volume and Lateral Wall Pressure in a Model Trachea

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Abstract
A D-shaped tracheal model with an elastic posterior wall was constructed, thus stimulating normal [human] tracheal anatomy more closely than previous models. The performance of 9-10 tracheal tube cuffs, of 2-3 different tube sizes (7.0-10.0 mm, ID [internal diameter]), from 6 different manufacturers were tested in the model. Cuff residual volumes ranged from 1.78-27.35 mo. Cuff pressure and lateral wall pressures exerted by the cuff on the model were measured at the time a seal was achieved which just prevented leakage of water past the cuff. When a seal was achieved with a volume of air in the cuff less than cuff residual volume, wall pressure tended to be low (< 35 torr) and cuff pressure closely approximated wall pressure. There was no relationship between cuff compliance and wall pressure. There were large differences between brands in the wall pressures required to effect a seal in the model. Intratracheal tubes should have cuffs with large residual volumes. This would permit some latitude in tube size selection while ensuring that a seal could be achieved before the cuff is inflated to its residual volume.

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