A Simple Method To Repair A Supraglottic Airway Device
Abstract Background: During the perioperative period or while in the intensive care unit, the inflation line is often cut accidentally during medical procedures or is damaged. As a result, it is not uncommon for a cuff leak to result in inadequate ventilation for the patient. The risk of using endotracheal tubes (ETTs) for secondary intubation is great, increasing the probability of respiratory tract infection and injury and even causing death in severe cases. The best method is to repair the damaged ETT to avoid secondary intubation and to ensure the safety of patients. Therefore, we recommend a practical and straightforward method to repair damage to the line or valve assembly of an endotracheal tube(ETT) and laryngeal mask airway (LMA).Methods: The distal end of a 22G vein (IV) catheter was inserted into the broken end of the inflation line. After insertion, the internal tube was withdrawn 1 mm to restore the inflation line. After 15 hours, the repaired ETT/LMA devices were tested for air leakage by measuring the pressure and load-bearing tension of the inflation line.Results: There was no difference in ETTs pressure between five intact ETTs and five repaired ETTs (Group A, ETT, mean difference = 0.2 cmH2O; 95% confidence interval 1.78 to 2.12 cmH2O; P = 0.82). When the cuff expanded to 120 cm H2O, there was no air leakage in the five ETTs after repair, and the tensile strength of the inflation line of the repaired ETTs in the experimental group was lower than that in the control group (each n = 5; mean difference = 33.3N; 95% confidence interval, 27.5 to 39.1N; P <0.001). There was no difference in LMAs pressure (Group B, LMAs, mean difference = 0.4 cmH2O; 95% confidence interval: -1.8 to −2.6 cmH2O; P = 0.67). When the cuff was expanded to 120 cmH2O, there was no air leakage from the five repaired LMAs. The tensile strength of the inflation line of the repaired LMAs in the experimental group was lower than that in the control group (n = 5; mean difference = −10; 95% confidence interval: −14 to −5.8 N; P = 0.001).Conclusion: When the ETT, LMA inflation line, or valve assembly is damaged or accidentally broken, an IV catheter can be directly inserted into the inflation line to quickly and effectively repair it. It is a safe and effective emergency remedial measure, which can be widely used in the clinic.