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Paediatr Anaesth. 2006 Feb;16(2):140-3.

Comparison of cuffed, uncuffed tracheal tubes and laryngeal mask airways in low flow pressure controlled ventilation in children.

Author information

1
Department of Anaesthesia and Intensive Care, Royal Aberdeen Children's Hospital, Aberdeen, UK. t.engelhardt@abdn.ac.uk

Abstract

BACKGROUND:

The use of low flow circle systems necessitates a 'leak free' breathing system which is commonly achieved by using a cuffed tracheal tube (TT). We hypothesized that low flow circle system anesthesia can equally effectively be achieved by using the LMA in pediatric anesthesia.

METHODS:

Following local ethics committee approval we randomly recruited 45 patients scheduled for elective surgery and requiring mechanical ventilation into three groups (cuffed TT, uncuffed TT and LMA group, n = 15). The size of the TT was determined by means of the formula (age/4) + 4.5 for uncuffed and (age/4) + 4 for cuffed TT whereas the size of the LMA size was dependent on weight. Following induction of anesthesia and muscle paralysis patients were ventilated with pressure controlled ventilation through a pediatric circle system and the lowest fresh gas flow (FGF) determined.

RESULTS:

The FGF achieved were (median and range) 0.20 (0.2-0.25) l.min(-1) for the LMA group, 0.20 (0.2-0.4) l.min(-1) for the cuffed TT group and 1.15 (0.2-4.75) l.min(-1) for the uncuffed group. The differences between the LMA and cuffed TT compared with the uncuffed TT were significant (P < 0.0001 and P = 0.0002, respectively). The difference in FGF between LMA and cuffed TT was not significant.

CONCLUSION:

We conclude that pressure controlled ventilation using an LMA is an alternative to a cuffed TT during low flow circle system anesthesia in children. Low FGF is unlikely to be achieved consistently using an uncuffed TT because of a substantial leak.

[Indexed for MEDLINE]

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