[Analysis of the intracuff pressures of intensive care patients].
OBJECTIVE
The intracuff pressure, when maladjusted, may cause complications. It is therefore important to measure it precisely and according to a routine. The objective of this study was to compare the intracuff pressures in the morning, afternoon and night shifts, and to measure pressures of the endotracheal tube (TOT) and the tracheotomy tube, comparing the results obtained and relating it with patients gender.


METHODS
In this descriptive and prospective study, the intracuff pressure of 72 intensive care unit patients (51 using TOT and 21 tracheotomy tube) was measured with a control-insufflator during the morning, afternoon and night shift changes. These pressures were adjusted when necessary, aided by the tracheal auscultation method and by the observation of the mouth air leaks.


RESULTS
Average pressures were 32.9+/-8.9 cmH2O, of which 36.7+/-1.6 cmH2O in the morning shift; 31.6+/-1.04 cmH2O in the afternoon shift; and 30.6+/-1.16 cmH2O in the night shift, with significance in the morning and afternoon shifts (p<0.001) and between the morning and night shifts (p<0.001). There was no significant change when compared with patients' gender. Comparison of the average intracuff pressures for the TOT (31.7+/-7.1 cmH2O) and the tracheotomy tube (36.1+/-11.8 cmH2O) was significant (p=0.05).


CONCLUSIONS
A routine of measuring intracuff pressures during the morning and night shifts should be established. Furthermore, a higher intracuff pressure in the tube was observed in patients who underwent tracheotomy, showing the importance of redoubling the care of these patients.
Camargo
Marina Furtado de
MF
Curso de Fisioterapia, Universidade Católica de Brasília, DF.
Andrade
Ana Paula Alves de
AP
Cardoso
Flávia Perassa de Faria
FP
Melo
Maria do Horto Obes de
Mdo H
D000368:Aged; D002940:Circadian Rhythm; D003422:Critical Care / Q000592:standards*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000592:standards*; D008297:Male; D011312:Pressure; D011446:Prospective Studies; D012121:Respiration, Artificial; D013997:Time Factors; D014132:Trachea / Q000293:injuries; D014140:Tracheotomy