Ricerca avanzata

Home > Riviste > Minerva Anestesiologica > Fascicoli precedenti > Minerva Anestesiologica 2016 Febbraio;82(2) > Minerva Anestesiologica 2016 Febbraio;82(2):236-9

FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOMINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

 

Minerva Anestesiologica 2016 Febbraio;82(2):236-9

 EXPERTS' OPINIONS

Could “safe practice” be compromising safe practice? Should anesthetists have to deflate the cuff of the endotracheal tube before extubation?

Hans J. PRIEBE

Department of Anesthesia, Albert-Ludwigs-University of Freiburg, Freiburg, Germany

Deflation of the cuff of the endotracheal tube (ETT) before tracheal extubation is considered mandatory and safe practice. However, there are potential shortcomings associated with this practice (e.g., aspiration around the uncuffed ETT, loss of positive airway pressure, difficulty in generating an effective cough at the time of extubation). By contrast, keeping the cuff inflated during extubation will minimize the risk of tracheal aspiration around the ETT, and it will reliably allow maintenance of positive airway pressure until extubation, effective lung recruitment before extubation, and generation of an effective cough during extubation. All of these factors might reduce the overall risk of immediate postextubation and postoperative respiratory and pulmonary complications. Mandatory monitoring of cuff pressure ensures a remaining rather small, highly compressible cuff volume around the ETT which is unlikely to carry per se the risk of producing laryngeal trauma. In my view, as the overall advantages of not deflating the cuff before extubation outweigh the disadvantages, anesthetists should not have to deflate the cuff of the ETT before extubation. Ultimately, only a randomized controlled trial will be able to assess the effect of such practice on patient outcome.

lingua: Inglese


FULL TEXT  ESTRATTI

inizio pagina