Fit and seal characteristics of a new paediatric tracheal tube with high volume-low pressure polyurethane cuff.

BACKGROUND

To evaluate a new paediatric tracheal tube (Microcuff, Weinheim, Germany) with an ultrathin high volume-low pressure polyurethane cuff.

METHODS

With approval of the Hospital Ethics Committee tracheas of children undergoing general anaesthesia were intubated using a Microcuff tube. Tube sizes were selected according to: internal diameter (mm) = age/4 + 3.5 in children aged > or = 2 years. In newborns (> or = 3 kg) < or = 1 year, ID 3.0-mm tubes, and in children from 1 to 2 years, internal diameter 3.5-mm tubes were used. Tubes were classified too large if no air leakage was obtained at an airway pressure of 20 cm H2O with the cuff not inflated. Sealing pressure was assessed by auscultation. Post-extubation croup requiring therapy was noted.

RESULTS

Five-hundred children were studied. In eight children the tubes were too large. Sealing pressure was 9.7 +/- 2.5 cm H2O (4-20). In two patients postextubation croup required singular short-term therapy.

CONCLUSIONS

Microcuff paediatric tracheal tubes provided tracheal sealing with cuff pressures considerably lower than usually accepted. The rate of tube exchange was very low (1.6%), as was the rate of airway morbidity (croup requiring therapy; 0.4%).