title: [Measurement of tube cuff pressure levels in intensive care unit: considerations on the benefits of training].
abstract: OBJECTIVE
  The tube cuff pressure directly transmitted on the tracheal wall in an irregular form can cause injuries and lead to bronchoaspiration. The aim of this study was to demonstrate that the implementation of routine tube cuff pressure measurements result in a reliable control to maintain the measurements within the parameters considered safe, thus preventing the described complications.
  
  
  METHODS
  A total of 3,195 tube cuff measurements were obtained from 1,194 male and female patients admitted at the Intensive Care Unit (ICU) and Coronary Unit (CU), who were undergoing mechanical ventilation with endotracheal prosthesis and tracheotomy cannula, during the morning and afternoon periods.
  
  
  RESULTS
  From March to August 2005 the follow-up of the measurements obtained by the physical therapy professionals was carried out and it was observed that the measurements were irregular, on average, in 80% of the cases. Thus, a training program was established, which was focused on the Nursing Teams of the ICU and CU, consisting in providing directions for the adequate procedures performed at the bedside (in loco training). The training procedures were carried out at two different periods (morning and afternoon) in order to include the whole team.
  
  
  CONCLUSIONS
  It is suggested that it is necessary to monitor tube cuff pressure through the implementation of routine measurements in the morning, afternoon and evening periods as a prophylactic measure, in order to prevent the possible complications of tracheal prosthesis balloon pressure.
authors.affiliation: Serviço de Fisioterapia, Hospital Santa Paula.
authors.forename: Silvia Renata Rezek
authors.initials: SR
authors.lastname: Juliano
authors.affiliation: Serviço de Fisioterapia, Hospital Santa Paula.
authors.forename: Maria Cecília Rezek
authors.initials: MC
authors.lastname: Juliano
authors.affiliation: Hospital Santa Paula.
authors.forename: Jose Paulo
authors.initials: JP
authors.lastname: Cividanes
authors.affiliation: Unidade de Terapia Intensiva Adulto, Hospital Santa Paula.
authors.forename: João Geraldo Simões
authors.initials: JG
authors.lastname: Houly
authors.affiliation: Unidade Coronariana, Hospital Santa Paula.
authors.forename: Otavio Celso Eluf
authors.initials: OC
authors.lastname: Gebara
authors.affiliation: Unidade de Terapia Intensiva B, Hospital Santa Paula.
authors.forename: Gil Vicente L
authors.initials: GV
authors.lastname: Cividanes
authors.affiliation: UNISÃOPAULO.
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Catão