Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 22;5(3):e16163.
doi: 10.5812/aapm.5(3)2015.16163. eCollection 2015 Jun.

Endotracheal Tube Cuff Pressure Assessment: Education May Improve but not Guarantee the Safety of Palpation Technique

Seyed Alireza Seyed Siamdoust  1 , Masood Mohseni  2 , Arash Memarian  2
Affiliations

Endotracheal Tube Cuff Pressure Assessment: Education May Improve but not Guarantee the Safety of Palpation Technique

Seyed Alireza Seyed Siamdoust et al. Anesth Pain Med. .

Abstract

Background: Endotracheal Tube Cuff Pressure (ETCP) should be kept in the range of 20 - 30 cm H2O. Earlier studies suggested that ETCP assessment by palpation of pilot balloon results in overinflation or underinflation and subsequent complications such as tracheal wall damage and aspiration.

Objectives: The current study aimed to evaluate the effect of an in vitro educational program on the ability of anesthesia personnel to inflate Endotracheal Tube Cuffs (ETT) within safe pressure limits.

Patients and methods: The survey included two series of blinded ETCP measurements in intubated patients before and two weeks after an in vitro educational intervention. The in vitro educational program included two separate trials. The anesthesia personnel were asked to inflate an ETT cuff inserted in a tracheal model using their usual inflation technique. In the same session, six ETTs at different pressure levels were examined by the participants and their estimation of ETCP was recorded. After the in vitro assessment, the participants were informed about the actual pressure of the in vitro ETCPs and were allowed to train their fingers by in vitro pilot balloon palpation with validated manometer measurements.

Results: The mean ETCP after the in vitro survey was significantly lower than the mean ETCP before the intervention (45 ± 13 vs. 51 ± 15 cm H2O, P = 0.002). The rate of measurements within the safe pressure limits significantly improved after the in vitro education (24.2% vs. 39.7%, P = 0.002).

Conclusions: Implementing educational programs with the introduction of estimation techniques besides the use of manometer as a standard intraoperative monitoring will improve the safety of the practice.

Keywords: Anesthesia; Education; Extubation, Airway; Methods; Palpation.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. The Three-Stage Protocol of the Study
See this image and copyright information in PMC

References

    1. Henderson J. Airway management in the adult. In: Miller RD, Eriksson LI, Wiener Kronish JP, Young WL, editors. Miller's Anesthesia. Philedelphia: Churhcil-Livingstone Elsevier; 2010. pp. 1573–610.
    1. Knowlson GT, Bassett HF. The pressures exerted on the trachea by endotracheal inflatable cuffs. Br J Anaesth. 1970;42(10):834–7. - PubMed
    1. Lu YH, Hsieh MW, Tong YH. Unilateral vocal cord paralysis following endotracheal intubation--a case report. Acta Anaesthesiol Sin. 1999;37(4):221–4. - PubMed
    1. Fan CM, Ko PC, Tsai KC, Chiang WC, Chang YC, Chen WJ, et al. Tracheal rupture complicating emergent endotracheal intubation. Am J Emerg Med. 2004;22(4):289–93. - PubMed
    1. Wain JJ. Postintubation tracheal stenosis. Semin Thorac Cardiovasc Surg. 2009;21(3):284–9. doi: 10.1053/j.semtcvs.2009.08.001. - DOI - PubMed

LinkOut - more resources