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Endotracheal tube cuffs - are two better than one?

Last post 02 Nov 2018, 5:00 AM by summit bloria. 0 replies.
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  •  02 Nov 2018, 5:00 AM 2681

    Endotracheal tube cuffs - are two better than one?

    We congratulate Bassi et al. for analysing the possibility of using a double-cuff for preventing  aspiration [1], but suggest that replacing endotracheal tube cuffs with the novel silicon cuffs might be a better option than 'adding (them) on' to a standard endotracheal tube, and would like to invite the authors to consider replying to the following points.

    Firstly,  a second cuff risks further attendant problems, such as shearing and malfunction.

    Secondly, we believe that addition of novel cuff significantly decreases the 'margin of safety' when correct placing an endotracheal tube, especially whenever the head position is changed. Flexion-extension of head can move the endotracheal tip by up to 4 cms, risking endobronchial intubation and vocal cord injury; indeed, in fig. 1, readers can see the novel cuff abutting the black line on endotracheal tube which indicates insertion depth at the level of the vocal cords.

    S. Bloria

    A. Luthra

    K. Kataria

     Postgraduate Institute of Medical Education and Research,

     Chandigarh, India.

    P. Bloria

    Government Medical College,

    Jammu, India.

    Email: summitbloria13@gmail.com


    No external funding and no conflicts of interest declared.



    1. Li Bassi G, Chiurazzi C, Aquilera E, et al. In‐vitro analysis of a novel ‘add‐on’ silicone cuff to improve sealing properties of tracheal tubes. Anaesthesia 2018; 72: 1372-81.  

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