Pressure damage to respiratory mucosa from overinflation of bronchial cuffs has been implicated as a cause of bronchial rupture, a rare but devastating complication of double-lumen endobronchial tubes (DLTs). In vivo, we evaluated the
pressure/volume
characteristics of the bronchial cuffs by left main bronchus diameter and DLT size.
Thirty patients were divided into three groups: in group 1, 35 Fr DLT was used and left main broncus diameter (LMBD) was less than 12 mm; in group 2, 37 Fr DLt and LMBD less than 12 mm; in group 3, 37 Fr DLT and LMBD larger than 12 mm. The
bronchial
cuff volume needed to seal left main bronchus(cuff sealing volume) and bronchial cuff pressure to 2.5 ml of cuff volume at 0.5 ml increments were measured.
@ES The results were as follows:
@EN 1) The mean±SE cuff sealing volume were 0.3±0.1 ml, 0.4±0.1 ml and 1.0±0.2 ml in group 1, 2 and 3 respectively.
2) The mean±SE bronchial cuff pressure at 0.5, 1, 1.5 and 2 ml of cuff volume were 27.5±5.0, 64.0±10.2, 105.4±15.5, 124.1±16.7 mmHg in group 1, 31.5±3.7, 74.1±6.2, 126.0±11.8, 175.3±14.6 mmHg in group 2 and 10.9±2.4, 23.8±3.4,
50.5±5.4,
89.2±7.5 mmHg in group 3 respectively.
We concluded that initial cuff inflation volume of 0.5 ml in group 1 and 2, 1ml in group 3 is appropriate.
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