Advanced cuff pressure control ventilation (ACPCV); a bench study of a new concept of mechanical ventilation

The concept of advanced cuff pressure control ventilation (ACPCV) is that the endotracheal tube (ETT) cuff volume could be controlled and allowed to exhale the gas through the vocal cords. The potential advantages of ACPCV are reduction of dead space, reduction of expiratory airway resistance, and p...

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Bibliographic Details
Published in:Journal of medical engineering & technology 2021-05, Vol.45 (4), p.324-333
Main Authors: Higeno, Ryota, Uchiyama, Akinori, Enokidani, Yusuke, Fujino, Yuji
Format: Article
Language:English
Subjects:
dead space
Endotracheal tube cuff
expiratory assistance
expiratory resistance
glottis function
Humans
Intubation, Intratracheal
Positive-Pressure Respiration
Respiration, Artificial
Trachea
Work of Breathing
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Summary:The concept of advanced cuff pressure control ventilation (ACPCV) is that the endotracheal tube (ETT) cuff volume could be controlled and allowed to exhale the gas through the vocal cords. The potential advantages of ACPCV are reduction of dead space, reduction of expiratory airway resistance, and preservation of vocal cord function. We developed the ACPCV system and investigated its performance in bench studies. The ETT cuff volume was regulated via four steps, depending on airway pressure and tracheal pressure. Two ventilatory settings were examined under several rates of spontaneous breathing efforts. Imposed expiratory resistance (R E ), imposed expiratory work of breathing (WOB), and auto-PEEP of ACPCV were compared with continuous mandatory ventilation (CMV). R E of ACPCV (2.6 ± 0.5 cm H 2 O/l/s) was significantly lower than that of CMV (11.6 ± 1.6 cm H 2 O/l/s) (p 
ISSN:0309-1902
1464-522X
DOI:10.1080/03091902.2021.1900437