Comparison of endotracheal cuff pressure measurements before and after nursing care in emergency patients: pilot balloon palpation

Abstract

Background: Manual inflation of tracheal tube cuff after intubation is necessary to provide a safe airway in intubated patients. An increase or decrease in the pressure of cuff balloon leads to serious complications such as mucosal necrosis and micro aspiration. The aim of the study was to compare the endotracheal tube cuff pressure measurements before and after selected nursing care in emergency patients underwent pilot balloon palpation during cuff inflation. Methods: A prospective cross-sectional design was utilized in the emergency department at Al Manial University Hospital upon a convenient sample of 100 mechanically ventilated patients from April 2016 to June 2017. Demographic and medical data were collected. Later, the endotracheal cuff pressure was checked with manometer before and 15 minutes after each nursing intervention and data were analyzed using SPSS software version 20. Results: The majority of the studied sample was male with mean age 47.09 ± 15. Significant differences were detected regarding Endotracheal suctioning (t=16.99, p=0.000), Changing body position (t=2.76, p=0.026) and sedating patients (t=3.951, P ≤ 0.0001). As changing patients’ body position to lateral sides, performing endotracheal and applying sedation caused a significant decrease in cuff pressure 15 minutes after. Conclusion: ETT cuff pressure was affected significantly with medical and nursing procedures and the pilot balloon palpation volume method was not suitable to estimate cuff pressure during intubation and the cuff pressure must be monitored and controlled by the manometers.