Anaesthetic and respiratory equipment - Cuff pressure indication, control and regulation devices (ISO 23371:2022)

This document specifies essential performance and safety requirements for cuff pressure indicators
used to indicate the intracuff pressure of airway devices, such as supralaryngeal airways, tracheal tubes
or tracheostomy tubes.
This document is also applicable to devices that combine intracuff pressure indication with a method
of cuff inflation (such as a syringe or pump). The device can also provide a method of automatically
maintaining cuff inflation at a specific pressure or within a pressure range.
The requirements specified in this document apply to stand-alone cuff pressure indicators and those
integrated into other medical devices (e.g. ventilators, anaesthesia workstations, etc.).

Anästhesie- und Beatmungsgeräte - Cuffdruckanzeiger und Cuffdruckregulierungsvorrichtungen (ISO 23371:2022)

Dieses Dokument legt wesentliche Leistungs- und Sicherheitsanforderungen von Cuffdruckanzeigen fest, mit denen der cuffinterne Druck von Atemwegsvorrichtungen, beispielsweise von supralaryngalen Atemwegen, Trachealtuben oder Tracheotomietuben, angezeigt wird.
Dieses Dokument ist auch für Produkte anwendbar, die die Anzeige des cuffinternen Drucks mit einer Methode zum Aufblasen des Cuffs (wie eine Spritze oder Pumpe) kombinieren. Das Produkt kann auch eine Methode zur automatischen Aufrechterhaltung des aufgeblasenen Cuffs bei einem bestimmten Druck oder innerhalb eines Druckbereichs bereitstellen.
Die in diesem Dokument angegebenen Anforderungen gelten sowohl für eigenständige Cuffdruckanzeiger als auch für Produkte, die in anderen Medizinprodukten integriert sind, wie z. B. in Beatmungsgeräten oder Anästhesie-Arbeitsplätzen usw.

Matériel d’anesthésie et de réanimation respiratoire - Dispositifs d’indication, de contrôle et de régulation de la pression du ballonnet (ISO 23371:2022)

Le présent document spécifie les exigences en matière de performances essentielles et de sécurité des indicateurs de pression du ballonnet utilisés pour indiquer la pression intraballonnet des dispositifs de voie aérienne, tels que les canules supralaryngées, les sondes trachéales ou les canules de trachéotomie.
Le présent document est également applicable aux dispositifs qui combinent l’indication de la pression intraballonnet à une méthode de gonflage du ballonnet (par exemple, seringue ou pompe). Le dispositif peut également fournir un moyen pour maintenir automatiquement le gonflage du ballonnet à une pression donnée ou dans une plage de pressions.
Les exigences spécifiées dans le présent document s’appliquent aux indicateurs de pression du ballonnet indépendants ainsi qu’à ceux intégrés à d’autres dispositifs médicaux, tels que des ventilateurs, des systèmes d’anesthésie, etc.

Anestezijska in dihalna oprema - Naprave za merjenje, kontrolo in regulacijo pritiska v balončku (ISO 23371:2022)

Ta dokument določa zahteve za bistvene lastnosti in varnost indikatorjev pritiska v balončkih, ki so namenjeni prikazovanju pritiska v balončku pripomočkov za dihalne poti, kot so supralaringealne dihalne cevke, trahealni tubusi ali traheostomski tubusi. Ta dokument se uporablja tudi za pripomočke, ki poleg prikaza pritiska v balončku omogočajo tudi metodo napihovanja balončka (na primer brizga ali črpalka). Pripomoček lahko zagotavlja tudi metodo samodejnega vzdrževanja pritiska v balončku na določeni vrednosti ali v določenem območju pritiska. Zahteve, določene v tem dokumentu, se uporabljajo za samostojne indikatorje pritiska v balončku in indikatorje pritiska, ki so vgrajeni v druge medicinske pripomočke (npr. ventilatorje, delovna mesta za anestezijo itd.).

General Information

Status
Published
Public Enquiry End Date
09-Jan-2020
Publication Date
23-Aug-2022
Technical Committee
Current Stage
6060 - National Implementation/Publication (Adopted Project)
Start Date
04-Aug-2022
Due Date
09-Oct-2022
Completion Date
24-Aug-2022

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Standards Content (Sample)

SLOVENSKI STANDARD
SIST EN ISO 23371:2022
01-september-2022
Anestezijska in dihalna oprema - Naprave za merjenje, kontrolo in regulacijo
pritiska v balončku (ISO 23371:2022)
Anaesthetic and respiratory equipment - Cuff pressure indication, control and regulation
devices (ISO 23371:2022)
Anästhesie- und Beatmungsgeräte - Cuffdruckanzeiger und
Cuffdruckregulierungsvorrichtungen (ISO 23371:2022)
Matériel d’anesthésie et de réanimation respiratoire - Dispositifs d’indication, de contrôle
et de régulation de la pression du ballonnet (ISO 23371:2022)
Ta slovenski standard je istoveten z: EN ISO 23371:2022
ICS:
11.040.10 Anestezijska, respiratorna in Anaesthetic, respiratory and
reanimacijska oprema reanimation equipment
SIST EN ISO 23371:2022 en
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

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SIST EN ISO 23371:2022

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SIST EN ISO 23371:2022


EN ISO 23371
EUROPEAN STANDARD

NORME EUROPÉENNE

June 2022
EUROPÄISCHE NORM
ICS 11.040.10
English Version

Anaesthetic and respiratory equipment - Cuff pressure
indication, control and regulation devices (ISO
23371:2022)
Matériel d'anesthésie et de réanimation respiratoire - Anästhesie- und Beatmungsgeräte -
Dispositifs d'indication, de contrôle et de régulation de Manschettendruck-Anzeigegeräte (ISO 23371:2022)
la pression du ballonnet (ISO 23371:2022)
This European Standard was approved by CEN on 17 March 2022.

CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this
European Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references
concerning such national standards may be obtained on application to the CEN-CENELEC Management Centre or to any CEN
member.

This European Standard exists in three official versions (English, French, German). A version in any other language made by
translation under the responsibility of a CEN member into its own language and notified to the CEN-CENELEC Management
Centre has the same status as the official versions.

CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia,
Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway,
Poland, Portugal, Republic of North Macedonia, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and
United Kingdom.





EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION

EUROPÄISCHES KOMITEE FÜR NORMUNG

CEN-CENELEC Management Centre: Rue de la Science 23, B-1040 Brussels
© 2022 CEN All rights of exploitation in any form and by any means reserved Ref. No. EN ISO 23371:2022 E
worldwide for CEN national Members.

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SIST EN ISO 23371:2022
EN ISO 23371:2022 (E)
Contents Page
European foreword . 3

2

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SIST EN ISO 23371:2022
EN ISO 23371:2022 (E)
European foreword
This document (EN ISO 23371:2022) has been prepared by Technical Committee ISO/TC 121
"Anaesthetic and respiratory equipment" in collaboration with Technical Committee CEN/TC 215
“Respiratory and anaesthetic equipment” the secretariat of which is held by BSI.
This European Standard shall be given the status of a national standard, either by publication of an
identical text or by endorsement, at the latest by December 2022, and conflicting national standards
shall be withdrawn at the latest by December 2022.
Attention is drawn to the possibility that some of the elements of this document may be the subject of
patent rights. CEN shall not be held responsible for identifying any or all such patent rights.
Any feedback and questions on this document should be directed to the users’ national standards
body/national committee. A complete listing of these bodies can be found on the CEN website.
According to the CEN-CENELEC Internal Regulations, the national standards organizations of the
following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria,
Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland,
Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Republic of
North Macedonia, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and the
United Kingdom.
Endorsement notice
The text of ISO 23371:2022 has been approved by CEN as EN ISO 23371:2022 without any modification.

3

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SIST EN ISO 23371:2022

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SIST EN ISO 23371:2022
INTERNATIONAL ISO
STANDARD 23371
First edition
2022-05
Anaesthetic and respiratory
equipment — Cuff pressure indication,
control and regulation devices
Matériel d’anesthésie et de réanimation respiratoire — Dispositifs
d’indication, de contrôle et de régulation de la pression du ballonnet
Reference number
ISO 23371:2022(E)
© ISO 2022

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SIST EN ISO 23371:2022
ISO 23371:2022(E)
COPYRIGHT PROTECTED DOCUMENT
© ISO 2022
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may
be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting on
the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address below
or ISO’s member body in the country of the requester.
ISO copyright office
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
Phone: +41 22 749 01 11
Email: copyright@iso.org
Website: www.iso.org
Published in Switzerland
ii
  © ISO 2022 – All rights reserved

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SIST EN ISO 23371:2022
ISO 23371:2022(E)
Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 General requirements . 2
4.1 General . 2
4.2 Alternative test methods . 2
5 Materials . 3
6 Design requirements .3
6.1 General . 3
6.2 Metrological requirements . 3
6.3 Connectors . 4
6.4 Integrated cuff pressure indicators . 4
6.5 Mechanical strength . 5
7 Requirements for Cuff pressure indication, control and regulation devices supplied
sterile . 5
8 Packaging. 6
9 Information supplied by the manufacturer . 6
9.1 General . 6
9.2 Marking . 6
9.2.1 General . 6
9.2.2 Markings . 6
9.3 Instructions for use . 6
Annex A (Informative) Rationale . 8
Bibliography . 9
iii
© ISO 2022 – All rights reserved

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SIST EN ISO 23371:2022
ISO 23371:2022(E)
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out
through ISO technical committees. Each member body interested in a subject for which a technical
committee has been established has the right to be represented on that committee. International
organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.
ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of
electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are
described in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the
different types of ISO documents should be noted. This document was drafted in accordance with the
editorial rules of the ISO/IEC Directives, Part 2 (see www.iso.org/directives).
Attention is drawn to the possibility that some of the elements of this document may be the subject of
patent rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of
any patent rights identified during the development of the document will be in the Introduction and/or
on the ISO list of patent declarations received (see www.iso.org/patents).
Any trade name used in this document is information given for the convenience of users and does not
constitute an endorsement.
For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and
expressions related to conformity assessment, as well as information about ISO's adherence to
the World Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT), see
www.iso.org/iso/foreword.html.
This document was prepared by Technical Committee ISO/TC 121, Anaesthetic and respiratory
equipment, Subcommittee SC 2, Airways and related equipment, in collaboration with the European
Committee for Standardization (CEN) Technical Committee CEN/TC 215, Respiratory and anaesthetic
equipment, in accordance with the Agreement on technical cooperation between ISO and CEN (Vienna
Agreement).
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.
iv
  © ISO 2022 – All rights reserved

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SIST EN ISO 23371:2022
ISO 23371:2022(E)
Introduction
This document provides the essential performance and safety requirements for the design of cuff
pressure indication and/or regulation devices for use with airway products. Cuffs on tracheal tubes and
tracheostomy tubes are intended to seal and protect the trachea from aspiration of secretions and to
provide an unobstructed airway in patients during spontaneous, assisted or controlled ventilation for
short or prolonged durations. Supralaryngeal airways feature an inflatable cuff to provide a guide for
insertion and stability of the airway. A variety of cuff designs are available to meet particular clinical
requirements. Cuffs on tracheal tubes and tracheostomy tubes function by forming a seal between the
airway device and the epithelial lining of the patient’s airway. A pressure will be exerted on the lining
of the airway where it makes contact with the cuff. Inflation of the airway cuff such that the pressure
exerted on the epithelium is in excess of the capillary perfusion pressure can result in ischemia of
the epithelium. This can result in short or long-term morbidity ranging from mild (e.g. sore throat) to
[1]
severe (e.g. subglottic stenosis) . Overinflated cuffs on supralaryngeal airways can cause injuries such
as damage to the lingual, hypoglossal or recurrent laryngeal nerves in addition to arytenoid dislocation,
[2]
haematoma, tongue swelling and cyanosis . Uncontrolled low airway cuff pressure can also increase
[3,4]
the risk of micro-aspiration and ventilator-associated pneumonia .
Tracheal tube and tracheostomy tube cuff pressures have traditionally been assessed by the clinician at
the time of cuff inflation. Typically this is done by listening for a leak at the mouth while inflating the
cuff with positive pressure applied to the airway until the user can no longer appreciate a leak. Evidence
[5]
suggests that such methods of clinical assessment of airway cuff pressure are inaccurate . A number
[6]
of clinical guidelines now recommend the measurement of cuff pressure using a suitable device .
Throughout this document the following print types are used:
— Requirements and definitions: roman type;
— Informative material appearing outside of tables, such as notes, examples and references: smaller
type. The Normative text of tables is also in smaller type;
— Terms defined in Clause 3: italic type.
v
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SIST EN ISO 23371:2022
INTERNATIONAL STANDARD ISO 23371:
...

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