Assessment of endotracheal cuff pressure by continuous monitoring: a pilot study.
BACKGROUND
Endotracheal tube cuff pressure must be maintained within a narrow therapeutic range to prevent complications. Cuff pressure is measured and adjusted intermittently.


OBJECTIVE
To assess the accuracy and feasibility of continuous monitoring of cuff pressure, describe changes in cuff pressure over time, and identify clinical factors that influence cuff pressure.


METHODS
In a pilot study, data were collected for a mean of 9.3 hours on 10 patients who were orally intubated and receiving mechanical ventilation. Sixty percent of the patients were white, mean age was 55 years, and mean intubation time was 2.8 days. The initial cuff pressure was adjusted to a minimum of 20 cm H2O. The pilot balloon of the endotracheal tube was connected to a transducer and a pressure monitor. Cuff pressure was recorded every 0.008 seconds during a typical 12-hour shift and was reduced to 1-minute means. Patient care activities and interventions were recorded on a personal digital assistant.


RESULTS
Values obtained with the cufflator-manometer and the transducer were congruent. Only 54% of cuff pressure measurements were within the recommended range of 20 to 30 cm H2O. The cuff pressure was high in 16% of measurements and low in 30%. No statistically significant changes over time were noted. Endotracheal suctioning, coughing, and positioning affected cuff pressure.


CONCLUSIONS
Continuous monitoring of cuff pressure is feasible, accurate, and safe. Cuff pressures vary widely among patients.
Sole
Mary Lou
ML
College of Nursing, Department of Statistics and Actuarial Science, Cardiopulmonary Science Program, University of Central Florida, Orlando, FL 32816-2210, USA. msole@ucf.edu
Penoyer
Daleen Aragon
DA
Su
XioaGang
X
Jimenez
Edgar
E
Kalita
Samar J
SJ
Poalillo
Elizabeth
E
Byers
Jacqueline F
JF
Bennett
Melody
M
Ludy
Jeffery E
JE
D003422:Critical Care / Q000379:methods*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010865:Pilot Projects; D011312:Pressure; D015203:Reproducibility of Results; D012121:Respiration, Artificial