Comparison of a novel lycra endotracheal tube cuff to standard polyvinyl chloride cuff and polyurethane cuff for fluid leak prevention

BACKGROUND: A high-volume low-pressure endotracheal tube (ETT) cuff forms folds along its contact with the trachea, allowing mucus leakage into the lungs. We developed a thin-walled ETT cuff made of Lycra polyurethane. METHODS: In vitro, we tested 6 of each of the new prototype Lycra cuff, the Mallinkrodt Hi-Lo ETT (polyvinyl chloride cuff), and the Kimberly-Clark Microcuff ETT (polyurethane cuff), for leakage, in an acrylic mock trachea (inner diameter 20-mm), with a cuff inflation pressure of 20 cm H2O. We poured 15 mL of methylene-blue colored water into the acrylic tube above the cuff and observed for leakage for 24 hours. RESULTS: The Lycra cuffs had no folds upon inflation in the mock trachea and completely prevented fluid leakage for 24 hours (P<.001 vs the Hi-Lo and the Microcuff). The average leakage past the Hi-Lo was 1,182\ub11,321 mL/h. The average leakage past the Microcuff was 1.2 \ub1 0.4 mL/h (P <.001 vs the Hi-Lo). CONCLUSIONS: Our Lycra cuff provided complete tracheal sealing in vitro