Abstract
Introduction: There is a correlation between endotracheal cuff pressure and airway complication; therefore, cuff pressure measurement is of an essential importance. The gold standard technique is measuring the cuff pressure by a calibrated manometer. However, there are several methods that injects air into balloon pilot and measures the cuff pressure. The aim of this study is to compare the tracheal cuff pressure measurement by two methods: fixed volume and minimal leak test (MLT). Methods: This descriptive study was performed at the emergency department on 110 patients. Patients were randomized into two groups. For one group, fixed volume technique and for the other group MLT was used. Results: Mean cuff pressure was 46.07±23.54 cmH2O in the fixed volume group and 33.72±9.14 cmH2O in the MLT group (P=0.05) which is significantly higher in the fixed volume group (P=0.028). In addition, 56.4% and 78.2% of the subjects had normal cuff pressure in the fixed volume group and MLT group, respectively; indicating a significantly higher rate in MLT group (P=0.025). Conclusion: Both techniques cause above normal intracuff pressure; however, MLT produces more acceptable pressure than fixed volume. It seems that the volume of 10 cc produces high pressures; therefore, fixed values may yield more appropriate results in lower volumes.
Highlights
There is a correlation between endotracheal cuff pressure and airway complication; cuff pressure measurement is of an essential importance
endotracheal tube (ETT) cuff pressure management is an important step in the management of airway after endotracheal intubation especially in critically ill patients who undergo mechanical ventilation
The mean age of the patients was 63.28±21.07 in the fixed volume group and 60.62±21.83 in the minimal leak test (MLT) group; there was no significant difference between two groups (P = 0.869)
Summary
There is a correlation between endotracheal cuff pressure and airway complication; cuff pressure measurement is of an essential importance. The injection of fixed amount of air by a syringe into endotracheal cuff is the most routine way This technique is easy, simple and not expensive, but the correlation between cuff to tracheal wall pressure and the volume of air is not linear and occasionally leads to cuff distention and over pressure.[14,15,16] In emergency situation, Tracheal tube cuff pressure it can be an appropriate method for application of secure airway but it could be dangerous and leads to different complication during time.[17,18] Harvie and colleagues in a cross-sectional study assessed the association between the cuff manometry and minimal leak test (MLT). Based on the different methods and various results, we designed a trial to compare the tracheal cuff pressure measurement by two methods: fixed volume and MLT
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