title: Endotracheal tube cuff pressure: need for precise measurement.
abstract: BACKGROUND
  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).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Post anesthesia care unit and intensive care unit.
  
  
  METHODS
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anesthesiology, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, Brazil. jbraz@fmb.unesp.br
authors.forename: J R
authors.initials: JR
authors.lastname: Braz
authors.forename: L H
authors.initials: LH
authors.lastname: Navarro
authors.forename: I H
authors.initials: IH
authors.lastname: Takata
authors.forename: P
authors.initials: P
authors.lastname: Nascimento Júnior
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009609:Nitrous Oxide / Q000008:administration & dosage; D011312:Pressure; D017678:Sex Distribution; D014132:Trachea / Q000293:injuries
chemical_list: D009609:Nitrous Oxide