title: Comparison of the endotracheal tube cuff pressure between a tapered- versus a cylindrical-shaped cuff after changing from the supine to the lateral flank position.
abstract: OBJECTIVE
  Positional change can displace an endotracheal tube (ETT) and change the ETT cuff pressure in a tracheally intubated patient. Endotracheal tubes with different cuff shapes may lead to different cuff pressures after positional change. We hypothesized that the intracuff pressure in the TaperGuard™ ETT with a tapered-shaped cuff would be higher than that in the conventional ETT with a cylindrical-shaped cuff after a change from the supine to the lateral flank position.
  
  
  METHODS
  Fifty-eight patients scheduled for open urological procedures in the lateral flank position were randomly allocated to receive either a TaperGuard ETT (group T) or conventional ETT (group C). The ETT cuff pressure was initially set at 20 cm H2O in the supine position and was measured after the change to the lateral flank position. The distance from the ETT tip to the carina was measured in both the supine and the lateral flank positions.
  
  
  RESULTS
  Two patients, one from each group, were excluded from the data analysis. The mean (SD) ETT cuff pressure was significantly higher in group T (n = 28) than in group C (n = 28) after the change in position [31 (7) cm H2O vs 25 (4) cm H2O, respectively; mean difference, 6 cm; 95% confidence intervals [CI], 3 to 9; P < 0.001]. The mean (SD) proximal migration of the ETT tip was comparable between the two groups [8 (18) mm vs 4 (14) mm, respectively; P = 0.367].
  
  
  CONCLUSIONS
  After the change from the supine to the lateral flank position, the ETT cuff pressure was significantly higher in the TaperGuard ETT than in the conventional ETT, although the extent of cephalad displacement of the ETT was comparable between the two groups. This trial was registered at Clinicaltrials.gov: NCT02165319.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Hospital, Daegu, Korea.
authors.forename: Hyun-Chang
authors.initials: HC
authors.lastname: Kim
authors.forename: Yong-Hun
authors.initials: YH
authors.lastname: Lee
authors.forename: Eugene
authors.initials: E
authors.lastname: Kim
authors.forename: Eun-Ah
authors.initials: EA
authors.lastname: Oh
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Jeon
authors.forename: Hee-Pyoung
authors.initials: HP
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011312:Pressure; D016037:Single-Blind Method; D013520:Urologic Surgical Procedures / Q000379:methods*