Improving the Mechanical Efficiency of Single Lung Ventilation

To reduce the occurrence of dislodgment of endotracheal tubes during single lung ventilation procedures in pediatric surgery, we have designed, prototyped and tested a new mechanical endotracheal tube cuff design combined with a biomaterial component. This novel design experiences greater friction with the bronchus and trachea than current devices, thereby increasing the amount of force required for tube dislodgement to occur. The new tube has most of the same features as the current standard of care but also includes an enhanced cuff. The cuff incorporates texturing that allows for better traction with the inner lining of the airways. In addition, the cuff is coated with a cellulose-based adhesive component that does not stick to the trachea but still makes removal the tube more difficult. To quantify how effectively our endotracheal tube design combats dislodgement, we used in vitro testing of excised piglet tracheas. We observed a 200 percent increase in the force required to dislodge our novel cuff design relative to the force required to dislodge cuffs that are considered the current standard of care. Future in vivo piglet testing will provide further data on dislodgement force in living specimens.