Endotracheal tube cuff pressure alteration after changes in position in patients under mechanical ventilation.
OBJECTIVE
The purpose of this study was to investigate endotracheal tube cuff pressure (Pcuff) alteration in patients under mechanical ventilation after changes in position.


METHODS
All selected patients were initially placed in the 35 degrees semi-Fowler position, with Pcuff adjusted to 20 mmHg, and randomly divided into two groups. Group A, in which patients were moved to the lateral decubitus position, facing away from the ventilator (measurement designated Pcuff A1), returned to the initial position (measurement designated Pcuff A2), moved to a lateral decubitus position, facing the ventilator (measurement designated Pcuff A3) and then returned to the initial position (measurement designated Pcuff A4); and Group B, in which patients were moved to the lateral decubitus position, facing the ventilator (measurement designated Pcuff B1), returned to the initial position (measurement designated Pcuff B2), moved to the lateral decubitus position; facing away from the ventilator (measurement designated Pcuff B3) and then returned to the initial position (measurement designated Pcuff B4).


RESULTS
The study comprised 70 patients, 31 allocated to group A and 39 allocated to group B. Values >22 mmHg were observed in 142(50.7%) of the 280 Pcuff measurements taken, and values <18 mmHg were observed in 14 (5%). When moved from the 35 degrees semi-Fowler position to the lateral decubitus position, facing away from the ventilator, 58 (82.2%) of the patients presented mean Pcuff values in the higher range (>22 mmHg).


CONCLUSIONS
Changes in body position can cause significant Pcuff variations in patients under mechanical ventilation.
Emergency Department Ward, University Hospital, State University at Campinas - School of Medicine, Campinas, Brazil. armandogodoy@ig.com.br
Armando Carlos Franco de
AC
Godoy
Ronan José
RJ
Vieira
Eduardo Mello De
EM
Capitani
D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000704:Analysis of Variance; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D011312:Pressure; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D014132:Trachea / Q000502:physiology; D055815:Young Adult