Comparison of tracheal tube cuff pressure with two techniques: fixed volume versus pilot balloon palpation.

Farzad Rahmani,Kavous Shahsavari Nia,Maryam Soleimanpour,Sarvin Sanaei,Hassan Soleimanpour,Jafar Rahimi Panahi,Ata Mahmoodpoor,Ali Zeynali,Robab Mehdizadeh Esfanjani

doi:10.15171/jcvtr.2017.34

Farzad Rahmani, Kavous Shahsavari Nia + Show 7 more

Open Access

https://doi.org/10.15171/jcvtr.2017.34

Copy DOI

Abstract

Introduction: Filling tracheal tube cuff (TTC) after intubation is necessary to provide a safe airway in intubated patients. On the other hand, excessive increase or decrease in the pressure of TTC’s balloon leads into the dangerous complications such as necrosis and/or aspiration. Accordingly, in the present study, we tried to evaluate the most two common fixed volume and pilot balloon palpitation methods to control TTC pressure. Methods: In a prospective cross-sectional study that was carried out in the emergency department of Tabriz Imam Reza hospital upon 194 patients who needed intubation and from April 2015 to June 2016. The patients were randomly allocated into two equal groups. For the first the Pilot Balloon Palpation technique and for the second group 10 cc fixed volume cuff filling technique was assigned. After that, the pressure was checked with manometer and data were analyzed using SPSS software. Results: TTC pressure average in fixed volume group was 44.96±21.77 cmH2O and for palpation group, it was 118.15±22.15 cmH2O. There was a meaningful difference between two groups in terms of cuff inside pressure (P value <0.001) and it was meaningfully lower in fixed volume group than the first one. Conclusion: The present study showed that pilot balloon palpation or fixed volume method was not appropriate methods to assess cuff pressure during intubation and the cuff pressure must be controlled by the manometer.

Highlights

Filling tracheal tube cuff (TTC) after intubation is necessary to provide a safe airway in intubated patients
Pilot balloon palpation has been introduced by medical staff as an alternative way to control cuff pressure duly to the facility of its procedure that could prevent the complications of excessive cuff pressure.[8]
In another study about TTC pressure, they demonstrated that cuff pressure must be controlled by manometer to prevent tracheal injury.[12]

Summary

Introduction

Intubation with endotracheal tube cuff (TTC) has been regarded as a benchmark of maintaining the airway among emergency patients.[1,2,3,4,5] To prevent air leakage, the cuff at the end of tracheal tube is usually filled with air during anesthesia.[6]. Pilot balloon palpation has been introduced by medical staff as an alternative way to control cuff pressure duly to the facility of its procedure that could prevent the complications of excessive cuff pressure.[8] In the emergency situation, it is common that cuff is filled with excessive air which in turn causes complications such as tracheal pain, vocal cord paralysis, tracheal stenosis, tracheoesophageal fistula formation and even tracheal perforation.[2] Sore throat in patients after anesthesia usually comes from ischemia in oropharyngeal and tracheal mucosa.[6] Long-term complications of excessive cuff pressure have. In another study about TTC pressure, they demonstrated that cuff pressure must be controlled by manometer to prevent tracheal injury.[12]

Materials and Methods

Results

Discussion