{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:16:45Z","timestamp":1785298605110,"version":"3.55.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004721","name":"The University of Tokyo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004721","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Proper management of aspirated material above the tracheostomy tube cuff is crucial to prevent complications, such as aspiration pneumonia. This study aimed to thoroughly examine the effects of aspirated liquid viscosity, suction port positioning, and tube tilt angle on residual volume above the cuff (RVAC).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Five types of tracheostomy tubes (approximately 9\u00a0mm outer diameter) were placed through a transparent cylinder with an inner diameter of 18\u00a0mm. The cuff was inflated to completely seal the interior of the cylinder. Four liquids with different viscosities were poured onto the cuff, and the liquid above the cuff was suctioned from the side port. The cylinder was angled at 90\u00b0 and 20\u00b0, and each test was performed thrice to determine the average RVAC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>After side-port suctioning, some liquid residue was observed on the cuff of all tracheostomy tubes. The RVAC increased with higher liquid viscosity. The tubes with a longer distance from the suction port opening to the cuff top exhibited more RVAC. Moreover, the RVAC was almost the same regardless of the cylinder angle for tubes with a suction port on the lateral side. However, tubes with backside ports showed a decreased RVAC with cylinder tilt.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study underscores the persistence of residual material on cuffed tracheostomy tubes even with regular subglottic secretion drainage. This emphasizes the need for specialized tracheostomy tube development aimed at reducing post-suction RVAC. Improved designs can potentially minimize complications associated with residue accumulation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00405-023-08281-6","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T13:02:14Z","timestamp":1697461334000},"page":"311-317","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Differences in residual volume above different tracheostomy tube cuffs depending on tube structure, tube tilt angle, and liquid viscosity"],"prefix":"10.1007","volume":"281","author":[{"given":"Takahiro","family":"Katsuno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0608-7237","authenticated-orcid":false,"given":"Rumi","family":"Ueha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiko","family":"Fujisaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Unno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel","family":"Cotaoco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asako","family":"Kaneoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misaki","family":"Koyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Goto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,16]]},"reference":[{"issue":"1","key":"8281_CR1","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1007\/s11940-013-0274-1","volume":"16","author":"J Bosel","year":"2014","unstructured":"Bosel J (2014) Tracheostomy in stroke patients. Curr Treat Options Neurol 16(1):274","journal-title":"Curr Treat Options Neurol"},{"issue":"8","key":"8281_CR2","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1056\/NEJM199902253400807","volume":"340","author":"MH Kollef","year":"1999","unstructured":"Kollef MH (1999) The prevention of ventilator-associated pneumonia. N Engl J Med 340(8):627\u2013634","journal-title":"N Engl J Med"},{"issue":"1","key":"8281_CR3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/000348941312200102","volume":"122","author":"LG Ledgerwood","year":"2013","unstructured":"Ledgerwood LG, Salgado MD, Black H, Yoneda K, Sievers A, Belafsky PC (2013) Tracheotomy tubes with suction above the cuff reduce the rate of ventilator-associated pneumonia in intensive care unit patients. Ann Otol Rhinol Laryngol 122(1):3\u20138","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"11","key":"8281_CR4","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1164\/rccm.200705-761OC","volume":"176","author":"L Lorente","year":"2007","unstructured":"Lorente L, Lecuona M, Jimenez A, Mora ML, Sierra A (2007) Influence of an endotracheal tube with polyurethane cuff and subglottic secretion drainage on pneumonia. Am J Respir Crit Care Med 176(11):1079\u20131083","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"8281_CR5","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1097\/CCM.0000000000001414","volume":"44","author":"DA Caroff","year":"2016","unstructured":"Caroff DA, Li L, Muscedere J, Klompas M (2016) Subglottic secretion drainage and objective outcomes: a systematic review and meta-analysis. Crit Care Med 44(4):830\u2013840","journal-title":"Crit Care Med"},{"key":"8281_CR6","doi-asserted-by":"publisher","first-page":"64","DOI":"10.11336\/jjcrs.13.64","volume":"13","author":"J Kayashita","year":"2022","unstructured":"Kayashita J, Fujishima I, Fujitani J et al (2022) The Japanese dysphagia diet of 2021 by the Japanese Society of Dysphagia Rehabilitation. Japanese J Compr Rehabilit Sci 13:64\u201377","journal-title":"Japanese J Compr Rehabilit Sci"},{"issue":"3","key":"8281_CR7","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.aucc.2018.03.007","volume":"32","author":"M Shamali","year":"2019","unstructured":"Shamali M, Abbasinia M, Ostergaard B, Konradsen H (2019) Effect of minimally invasive endotracheal tube suctioning on physiological indices in adult intubated patients: An open-labelled randomised controlled trial. Australian Crit Care 32(3):199\u2013204","journal-title":"Australian Crit Care"},{"issue":"5","key":"8281_CR8","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1097\/TA.0b013e318247cd33","volume":"72","author":"F Wang","year":"2012","unstructured":"Wang F, Bo L, Tang L et al (2012) Subglottic secretion drainage for preventing ventilator-associated pneumonia: an updated meta-analysis of randomized controlled trials. J Trauma Acute Care Surg 72(5):1276\u20131285","journal-title":"J Trauma Acute Care Surg"},{"issue":"8","key":"8281_CR9","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1097\/CCM.0b013e318218a4d9","volume":"39","author":"J Muscedere","year":"2011","unstructured":"Muscedere J, Rewa O, McKechnie K, Jiang X, Laporta D, Heyland DK (2011) Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis. Crit Care Med 39(8):1985\u20131991","journal-title":"Crit Care Med"},{"issue":"1","key":"8281_CR10","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1053\/j.jvca.2014.04.026","volume":"29","author":"JK Hudson","year":"2015","unstructured":"Hudson JK, McDonald BJ, MacDonald JC, Ruel MA, Hudson CC (2015) Impact of subglottic suctioning on the incidence of pneumonia after cardiac surgery: a retrospective observational study. J Cardiothorac Vasc Anesth 29(1):59\u201363","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"8","key":"8281_CR11","doi-asserted-by":"publisher","first-page":"844","DOI":"10.23736\/S0375-9393.20.13989-0","volume":"86","author":"P Terragni","year":"2020","unstructured":"Terragni P, Urbino R, Mulas F et al (2020) Occurrence of ventilator associated pneumonia using a tracheostomy tube with subglottic secretion drainage. Minerva Anestesiol 86(8):844\u2013852","journal-title":"Minerva Anestesiol"},{"issue":"2","key":"8281_CR12","doi-asserted-by":"publisher","first-page":"e001269","DOI":"10.1136\/bmjoq-2020-001269","volume":"10","author":"N Weston Smith","year":"2021","unstructured":"Weston Smith N, Spivey M (2021) Promoting subglottic secretion drainage: a quality improvement project in a UK critical care unit. BMJ Open Quality. 10(2):e001269","journal-title":"BMJ Open Quality."},{"issue":"4","key":"8281_CR13","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1093\/bja\/aes210","volume":"109","author":"R Amathieu","year":"2012","unstructured":"Amathieu R, Sauvat S, Reynaud P et al (2012) Influence of the cuff pressure on the swallowing reflex in tracheostomized intensive care unit patients. Br J Anaesth 109(4):578\u2013583","journal-title":"Br J Anaesth"},{"issue":"6","key":"8281_CR14","doi-asserted-by":"publisher","first-page":"956","DOI":"10.4187\/respcare.02920","volume":"59","author":"DR Hess","year":"2014","unstructured":"Hess DR, Altobelli NP (2014) Tracheostomy tubes. Respirat Care 59(6):956\u2013971 (discussion 971-953)","journal-title":"Respirat Care"},{"issue":"12","key":"8281_CR15","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1007\/s12630-022-02333-x","volume":"69","author":"SR Sibley","year":"2022","unstructured":"Sibley SR, Ball IM, D\u2019Arsigny CL et al (2022) Airway injury from the presence of endotracheal tubes and the association with subglottic secretion drainage: a prospective observational study. Can J Anaesthesia J canadien d\u2019anesthesie. 69(12):1507\u20131514","journal-title":"Can J Anaesthesia J canadien d'anesthesie."}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-023-08281-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-023-08281-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-023-08281-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T12:08:31Z","timestamp":1704283711000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-023-08281-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,16]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["8281"],"URL":"https:\/\/doi.org\/10.1007\/s00405-023-08281-6","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,16]]},"assertion":[{"value":"22 August 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 October 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study is not subject to ethical review.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}