title: Assessment of endotracheal cuff pressure by continuous monitoring: a pilot study.
abstract: 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.
authors.affiliation: College of Nursing, Department of Statistics and Actuarial Science, Cardiopulmonary Science Program, University of Central Florida, Orlando, FL 32816-2210, USA. msole@ucf.edu
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Sole
authors.forename: Daleen Aragon
authors.initials: DA
authors.lastname: Penoyer
authors.forename: XioaGang
authors.initials: X
authors.lastname: Su
authors.forename: Edgar
authors.initials: E
authors.lastname: Jimenez
authors.forename: Samar J
authors.initials: SJ
authors.lastname: Kalita
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Poalillo
authors.forename: Jacqueline F
authors.initials: JF
authors.lastname: Byers
authors.forename: Melody
authors.initials: M
authors.lastname: Bennett
authors.forename: Jeffery E
authors.initials: JE
authors.lastname: Ludy
mesh_terms: 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