Endotracheal tube cuff pressure: need for precise measurement.
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.
Braz
J R
JR
Department of Anesthesiology, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, Brazil. jbraz@fmb.unesp.br
Navarro
L H
LH
Takata
I H
IH
Nascimento Júnior
P
P
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
D009609:Nitrous Oxide