Tracheal tube cuffs and tracheal dilatation.

Although tracheal tube cuffs are well known to injure the trachea, attempts to design safer cuff systems have been only partially successful. In 14 dogs, we compared three models of high residual volume, low pressure cuffs, which are considered to be among the safest. Two were air-filled cuffs -- a maintained pressure cuff and a balloon reservoir cuff -- and the third was foam-filled. Tracheal dilatation was considerably more severe with mechanical ventilation than with spontaneous breathing, but the foam cuff produced significantly less dilatation (P less than .005) than the air-filled cuffs.