Continuous monitoring of endotracheal tube cuff pressure: best practice in intensive care unit

Abstract

The endotracheal tube cuff pressure must be maintained within an optimal range of 20-30 cmH2O, which ensures ventilation, prevents aspiration of secretions and guarantees a good tracheal perfusion. To describe changes in the endotracheal tube cuff pressure over time through a continuous monitoring device, and assess the number of nursing actions. Observation of 72 patients admitted to a general ICU and monitored for 12 hours, with a continuos monitoring device of endotracheal tube cuff pressure (PressureEasy(®)). During the first four hours 4 cases (5.6%) of underinflated cuff were observed, and 5 (6.9%) of overinflation. From the fifth to the eighth hour 7 (9.7%) patients showed a pressure <20 cmH2O, and 3 (4.2%) >30 cmH2O. During the last four hours 22 cases (30.5%) of underinflated cuff, and 4 (5.6%) of overinflation were observed. More than half of the patients (n=38, 52.8%) did not require any intervention of inflation or deflation of the cuff, 25 (34.7%) only one and 7 (9.7%) patients two, and twe patients, three. The majority of patients required the inflation of the cuff. Our study supports the need of continuous endotracheal tube cuff pressure monitoring to promptly identify deviations from the pressure ranges, allowing their rapid correction.