Endotracheal tube cuff pressure: need for precise measurement

Sao Paulo Medical Journal

José Reinaldo Cerqueira Braz¹  Lais Helena Camacho Navarro²  Ieda Harumi Takata¹  Paulo Nascimento Júnior¹ 

[1] ,Universidade Estadual PaulistaBotucatu,Brazil

关键词: Tracheal tube;    Intracuff pressure;    Nitrous oxide;    Tubo traqueal;    Pressão do balonete;    Óxido nitroso;   

DOI  :  10.1590/S1516-31801999000600004

来源: SciELO

【 摘 要 】

CONTEXT: High compliance endotracheal tubes cuffs are used to prevent gas leak and also pulmonary aspiration in mechanically ventilated patients. However, the use of the usual cuff inflation volumes may cause tracheal damage. OBJECTIVE: We tested the hypothesis that endotracheal tube cuff pressures are routinely high (above 40 cmH2O) in the Post Anesthesia Care Unit (PACU) or Intensive Care Units (ICU). DESIGN: Cross-sectional study. SETTING: Post anesthesia care unit and intensive care unit. PARTICIPANTS: We measured endotracheal tubes cuff pressure in 85 adult patients, as follows: G1 (n = 31) patients from the ICU; G2 (n = 32) patients from the PACU, after anesthesia with nitrous oxide; G3 (n = 22) patients from the PACU, after anesthesia without nitrous oxide. Intracuff pressure was measured using a manometer (Mallinckrodt, USA). Gas was removed as necessary to adjust cuff pressure to 30 cmH2O. MAIN MEASUREMENTS: Endotracheal tube cuff pressure. RESULTS: High cuff pressure (> 40 cmH2O) was observed in 90.6% patients of G2, 54.8% of G1 and 45.4% of G3 (P < 0.001). The volume removed from the cuff in G2 was higher than G3 (P < 0.05). CONCLUSION: Endotracheal tubes cuff pressures in ICU and PACU are routinely high and significant higher when nitrous oxide is used. Endotracheal tubes cuff pressure should be routinely measured to minimize tracheal trauma.

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