28. Contraindications and Side Effects

28. Contraindications and Side Effects

The Tulip is contraindicated in non-fasted Patients and those at risk of aspiration, such as the grossly obese, those with hiatus hernia, previous opiate analgesia, those with a recent traumatic injury, massive or multiple injury, those of greater than 14 weeks gestation, those with an autonomic neuropathy and those with an acute abdomen, reduced gastric emptying or dilation of the stomach.

The Tulip may be effectively used to high ventilatory pressures (>20cmH2O) and these pressures may be relied upon in times of emergency ventilation but they require down-regulation using the pressure regulating valve upon the anaesthetic breathing circuit to prevent Patient harm and gastric dilation.

This ability of the Tulip to ventilate at high pressures should be used with caution, as high ventilating pressures induce gastric dilation which may induce the regurgitation of gastric contents. The Tulip’s ability to ventilate at high pressures means that it may be used in those with a low chest compliance. It is, however, not recommended for prolonged use in those who require in excess of 20cmH2O of ventilatory pressure. To further reduce gastric dilation it is recommended to reduce the inspiratory flow rate as well as the peak ventilatory pressures.

The Tulip is the most atraumatic airway available by design as all that makes contact with the mucosa of the oropharynx is soft, inflatable, high-volume, low-pressure plastic balloon-cuff. Studies as to the consequences of long term use are unknown at this time but are expected to mirror the reduced levels of sore throat, dysarthria and dryness encountered thus far. The Tulip also removes the possibility of instrument induced laryngospasm or laryngeal nerve trauma.