[Monitoring of tracheal tube cuff pressure in patients treated in intensive therapy unit and intensive care units].
OBJECTIVE
Proper tracheal tube cuff pressure (CP) can diminish the risk of side effects. Excessive tracheal tube cuff pressure can cause ischaemic changes in the tracheal mucosa, decubitation, granuloma, rupture of a trachea, tracheo-oesophageal fistulae or tracheal stenosis. Too low CP is also undesirable, because it can increase the leakage of colonized subglottic secretions around the tracheal tube cuff, which is the risk factor of ventilatory associated pneumonia. Accidental extubation may also occur. The aim of the study was to find out if there are any differences in maintenance of the proper CP between the staff of intensive therapy unit (ITU) under the supervision of anaesthesiologists and staff of intensive care units (ICU) led by non-anaesthesiologists.


METHODS
We measured the CP in 219 intubated patients. There were 107 patients hospitalized in ITU, under anaesthesiologists's surveillance, the other 112 patients in ICUs were supervised by non-anaesthesiologists. The patients were intubated with Portex Profile Soft-Seal Cuff and Mallinckrodt Hi-Lo with low-pressure and high-volume cuffs. The manometer PORTEX with the recommended range of CP 16-26 cm H2O (1.56-2.54 kPa). The teams were unaware that the audit was taking place. If the CP was out of range, it was corrected to the proper values.


CONCLUSIONS
The data analysis did not reveal any differences between values of CP in both groups of subjects. Over-inflation was more frequent than under-inflation in both groups of patients. Regular measurement of tracheal cuff pressure was not a routine procedure in the controlled units.
Wujtewicz
Magdalena A
MA
Klinika Anestezjologii i Intensywnej Terapii, Akademii Medycznej w Gdańsku. magwuj@amg.gda.pl
Sawicka
Wioletta
W
Sein Anand
Jacek
J
Owczuk
Radosław
R
Wujtewicz
Maria
M
Puchalski
Wiesław
W
Bukowska
Agnieszka
A
Chodorowski
Zygmunt
Z
D000776:Anesthesiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D008991:Monitoring, Physiologic; D011312:Pressure / Q000009:adverse effects; D000078329:Workforce