• Alice R Bird, David J Bird, and Matthew W McMillan.
• Department of Veterinary Medicine, University of Cambridge, Cambridge, UK. Electronic address: alicerachaelbird@gmail.com.
• Vet Anaesth Analg. 2019 Jan 1; 46 (1): 55-63.

ObjectivesTo determine the endotracheal tube cuff pressure produced with two inflation techniques, in two brands of endotracheal tube in cats. To determine the inspiratory pressure which produces an audible leak when the intracuff pressure is 30 cmH2O.Study DesignProspective, clinical, randomized study.AnimalsA total of 40 client-owned healthy adult cats.MethodsFollowing induction of anaesthesia, endotracheal intubation was performed with a Parker Flex-Tip PFLP (Parker; n = 20) or Flexicare VentiSeal (Flexicare; n = 20) endotracheal tube. For each cat, the endotracheal tube cuff was inflated using two methods, minimum occlusive volume (MOV) and pilot balloon palpation (PBP). Intracuff pressure was recorded. Cuff pressure was then set at 30 cmH2O and the pressure within the breathing system when a manual breath first caused an audible leak was measured.ResultsPBP pressure was lower for Parker (36 ± 13 cmH2O) compared with Flexicare (45 ± 13 cmH2O, p = 0.048). MOV pressure was not different between tube types (56 ± 28 versus 66 ± 25 cmH2O for Parker and Flexicare, respectively, p = 0.247). MOV produced a higher pressure than PBP for Parker (56 ± 28 versus 36 ± 13 cmH2O, p = 0.001) and Flexicare (66 ± 25 versus 45 ± 13 cmH2O, p = 0.007). When intracuff pressure was set at 30 cmH2O, 95% of cats did not develop an audible leak until the inspiratory pressure was greater than 10 and 12 cmH2O for Parker and Flexicare tubes, respectively.ConclusionsPBP produced lower cuff pressures than MOV, although both techniques produced a cuff pressure above that at which mucosal blood flow is believed to be restricted. A cuff pressure of 30 cmH2O may be sufficient to prevent audible leak in most cats if respiratory pressures are kept at 10-12 cmH2O or below.Clinical RelevanceTo ensure a safe endotracheal tube cuff pressure, use of a specifically designed pressure gauge is recommended.Copyright © 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

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