CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by FINHOLT, D. A.
Right arrow Articles by RAPHAELY, R. C.
Right arrow Search for Related Content
PubMed
Right arrow Articles by FINHOLT, D. A.
Right arrow Articles by RAPHAELY, R. C.

Canadian Journal of Anesthesia, Vol 32, 326-329, Copyright © 1985 by Canadian Anesthesiologists' Society

Factors Affecting Leak around Tracheal Tubes in Children

DAVID A. FINHOLT MD1, DESMOND B. HENRY MD1, and RUSSELL C. RAPHAELY MD1

1 Department of Anesthesiology, Children's Hospital of Philadelphia and Department of Anesthesiology, University of Pennsylvania, Philadelphia, Pennsylvania

Address correspondence to: Dr. David A. Finholt, Department of Anesthesiology, Box 238, University of Virginia Medical Center, Charlottesville, VA 22908.

This study determined which variables affected endotracheal tube "leak" pressures in 80 surgical patients, two weeks to ll years of age, intubated with uncuffed tracheal tubes. We defined "leak" pressure as the inspiratory pressure needed to cause an audible escape of gas around the endotracheal tube. "Leak" pressure was measured after varying either head position, tracheal tube depth within the trachea, fresh gas flow rate, or degree of neuromuscular block. "Leak" pressure increased progressively from 16.9 ± 1.3 cm H2O with complete patient paralysis to 30.6 ± 1.4 cm H2O following 100 per cent recovery of neuromuscular function. Turning the head from a neutral position to one side increased "leak" pressure from 14.7 ± 1.7 cm H2O to 24.4 ±2.5 cm H2O. Varying tracheal tube depth or fresh gas flow rate produced no significant change in "leak" pressure. Thus, there may be marked variability in "leak" pressure, depending on head position and degree of neuromuscular blockade. Keeping the patient fully paralyzed with the head in a neutral position provides a reliable and consistent method for measuring "leak" pressures.

Key Words: ANAESTHESIA: paediatric • INTUBATION: endotracheal






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1985 by the Canadian Anesthesiologists' Society.