Join Date: May 2006
Location: Ann Arbor/Ypsilanti
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Had to wait for DH to get home for this one.
He says cuffed tubes are for adults, uncuffed are for peds.
Having the cuffed tube inflated DOES protect the airway from aspiration, BUT you put the patient under THEN insert the tube, leaving the opportunity for aspiration after patient is under but before tube is inserted and inflated.
There is also the risk of aspiration AFTER the tube is removed but before the patient is fully alert again.
Does that make sense?
Edited to add he said IF the tube is inflated exactly as it should be with no space whatsoever, the patient won't aspirate with it in place, but you are still left with the time before the tube is in place and after it is removed but before patient is alert that the concern for aspiration is highest, thus the no food or drink rule. Also, even the tiniest bit of error can allow liquid contents to enter the lungs, so it's just a whole lot simpler if patient has an empty stomach.
Except that pregnant women, by definition, never have empty stomachs (progesterone causes delayed emptying), and gastric secretions (with their pH of 1) have been shown to cause aspiration pneumonia.
Must have lucked out, because I know I've been intubated with an uncuffed ET as an adult, and damn, that was more comfortable the next day. Or my anesthesiologist was confused as to my age .
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