title: Decrease in cuff pressure during the measurement procedure: an experimental study.
abstract: BACKGROUND
  To prevent endotracheal tube (ETT)-related complications during mechanical ventilation, ETT cuff pressure should be kept within proper range. In clinical settings, cuff pressure often decreases from target values.
  
  
  METHODS
  We performed an experimental study to investigate the effects of measuring devices and endotracheal tubes on change in cuff pressure. We continuously measured cuff pressure by inserting a three-way stopcock in the middle of an ETT pilot balloon system. After adjusting the cuff pressure to 24 cmH2O, we disconnected and reconnected each cuff inflator to the inflation valve of the ETT and measured the changes in the cuff pressure. We measured the change in cuff pressure with different ETT sizes, cuff shapes, brands of cuff inflator, and with and without added extension tubes.
  
  
  RESULTS
  The cuff pressure decreased, on average, by 6.6 cmH2O (standard deviation 1.9), when connecting the cuff inflator to the pilot balloon. The measured cuff pressure was less than 20 cmH2O in 67% of the tests. The cuff pressure decreased more when an extension tube was used. The brand of cuff inflator made no difference to the pressure loss. The cuff pressure decreased more with ETTs of smaller size and with ETTs with pyriform cuffs.
  
  
  CONCLUSIONS
  Procedures to connect cuff inflators to inflation valves resulted in the loss of cuff pressure by 6.6 cmH2O on average.
authors.affiliation: The University of Tokushima Graduate School, Tokushima, 770-0855 Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Asai
authors.affiliation: The University of Tokushima Graduate School, Tokushima, 770-0855 Japan.
authors.forename: Asuka
authors.initials: A
authors.lastname: Motoyama
authors.affiliation: The University of Tokushima Graduate School, Tokushima, 770-0855 Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: The University of Tokushima Graduate School, Tokushima, 770-0855 Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konami
authors.affiliation: Emergency and Disaster Medicine, Tokushima University Hospital, Tokushima, 770-8503 Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Imanaka
authors.affiliation: Emergency and Critical Care Medicine, Tokushima University Hospital, Tokushima, 770-8503 Japan.
authors.forename: Masaji
authors.initials: M
authors.lastname: Nishimura
keywords: Cuff inflator; Cuff pressure; Cuff shape; Endotracheal tube