[Effects of tracheal tube cuff limit pressure (25 cmH2O) and "seal" pressure on tracheal mucosa of dogs.].

BACKGROUND AND OBJECTIVES Injuries of tracheal mucosa in contact with tracheal tube cuff is a function of cuff pressure and exposure time. This study aimed at analyzing injuries of tracheal mucosa in contact with tracheal tube cuff inflated to reach "seal" pressure or limit 25 cmH2O pressure, below critical 30 cmH2O, to prevent tracheal damage. METHODS This study involved 16 dogs submitted to intravenous anesthesia and artificial ventilation. Dogs were randomly distributed into two experimental groups according to tracheal tube cuff pressure (Portex Blue Line, UK): Gseal (n = 8) cuff with minimum "seal" pressure to prevent air leakage during artificial ventilation; G25 (n=8) cuff inflated to 25 cmH2O. Cuff pressure was measured with a digital manometer at the beginning of the experiment (control) and 60, 120 and 180 minutes later. Animals were sacrificed and tracheal mucosa areas adjacent to the tracheal tube cuff were biopsed by scanning electronic microscopy (SEM). RESULTS Mean cuff pressure was maintained between 24.8 and 25 cmH2O in G25 and between 11.9 and 12.5 cmH2O in Gseal. SEM changes were mild and not significantly different between groups (p > 0.30), with more severe injuries to tracheal areas in contact with the cuff as compared to areas adjacent or not to tracheal tube (p < 0.05). CONCLUSIONS In dogs under our experimental conditions, tracheal tube cuff inflation to 25 cmH2O limit or to "seal" pressure to prevent air leakage has determined minor injuries to the tracheal mucosa in contact with tracheal tube cuff, without significant differences between groups.