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Endotracheal intubation with a cuffed tube is thought to prevent pulmonary aspiration, but studies have shown that small amounts of liquids can bypass the cuff by following the longitudinal folds in the cuff wall. These investigators in the U.K. compared cuffs lubricated with water-soluble gel and nonlubricated cuffs in a laboratory model and in a randomized, double-blind, clinical trial.
The laboratory model used a rigid cylinder and a pig trachea. All of the nonlubricated cuffs leaked, but none of the lubricated cuffs did. In the clinical trial, 36 surgical patients were anesthetized using the standard technique and were intubated with an unlubricated tube or a tube lubricated with 5 of water-soluble gel. During anesthesia, 3.5 mL of dilut…