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Cuff pressure control of the tracheal tube: a prospective study in a general ICU

Introduction

High pressures of the tracheal tube cuffs can impair damage for restriction of the air flow.

Objectives

To demonstrate the prevalence of high pressures of the tracheal cuff in orotracheal tubes (OTTs) and tracheotomies (TCT). To verify the impact of cuff pressure control on further cuff volume adjustment.

Methods

This is a transversal study, which evaluated every tracheally intubated (OTT or TCT) patient in a general or neurosurgery ICU. Daily we have measured cuff pressures with a mercury manometer. The pressure goal was 20 mmHg (27.2 cmH2O).

Results

One hundred and six patients were evaluated, 75 (71%) male. Their age ranged from 16 to 92 years (mode 85 years). Forty-two (39%) patients had undergone TCT and 64 (61%) had undergone OTT. The first-day APACHE II score ranged from 4 to 39 (mode 22) and the average mortality risk was 27.5%. The length of time of OTT ranged from 1 to 16 days (mode 8 days) and that for TCT from 5 to 70 days (mode 5 days). The initial pressures ranged from <20 mmHg to 140 mmHg (mode <20 mmHg). After initial reduction of the cuff volumes, the range of the pressures decreased (from <20 mmHg to 80 mmHg).

Conclusion

Increased prevalence of high pressures of the cuff in tracheal tubes justifies frequent monitoring of this parameter, aiming at brightening up the deleterious effect of the drawn-out use of these tubes.

References

  1. Wujtewicz MA, Sawicka W, Sein Anand J, et al.: Monitoring of tracheal tube cuff pressure in patients treated in intensive therapy unit and intensive care units. Przegl Lek 2004, 61: 353-355.

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Cardoso, G., Guimarães, H., Lopes, R. et al. Cuff pressure control of the tracheal tube: a prospective study in a general ICU. Crit Care 9 (Suppl 2), P79 (2005). https://doi.org/10.1186/cc3623

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  • DOI: https://doi.org/10.1186/cc3623

Keywords

  • Initial Pressure
  • Tracheal Tube
  • Cuff Pressure
  • Frequent Monitoring
  • Initial Reduction