Abstract
Introduction: Maintaining endotracheal tube intracuff pressure (ETTICP) within an optimal range is crucial for effective ventilation and prevention of aspiration. This study aimed to determine the effect of changing body position on ETTICP in patients under mechanical ventilation.Methods: In the current single-group study, each patient was taken as his/her own control. Thirty patients who met the inclusion criteria were selected as the study sample. First, the patients were placed in a supine (flat) position, head of the bed was raised to 30 degrees, and ETTICP was set at 25 cmH2 O as the baseline. Then, the ETTICP changes in the three positions (left lateral, right lateral, and semi-fowler) were compared with the baseline. Interventions were made on a random basis among the patients. Data were analyzed by repeated-measures ANOVA using SPSS version 13.Results: There was a significant difference among ETTICP means in three different body positions, so that ETTICP was higher in the left lateral position compared to other positions. Moreover, there was a significant difference among ETTICP means 0, 15, 45, and 90 minutes after changing the body position. ETTICP means after 0 and 15 minutes were significantly higher than other times compared to the baseline.Conclusion: ETTICP changes were affected by different body positions and the passage of time. Thus, regular monitoring and adjusting of ETTICP after any body positioning is essential, especially immediately and 15 minutes after repositioning.
Highlights
Maintaining endotracheal tube intracuff pressure (ETTICP) within an optimal range is crucial for effective ventilation and prevention of aspiration
The ETTICP in patients under mechanical ventilation in intensive care unit (ICU) was influenced by two important factors, including body position and the passage of time
The ETTICP increased as the position changed, and these changes were varied in different positions
Summary
Maintaining endotracheal tube intracuff pressure (ETTICP) within an optimal range is crucial for effective ventilation and prevention of aspiration. This study aimed to determine the effect of changing body position on ETTICP in patients under mechanical ventilation. The cuff must be sufficiently filled 4,5 and kept within the normal range of 20-30 cmH2O for adequate mechanical ventilation.[6,7] Pressure variation outside this range causes some complications for patients.[8-10]. The insufficient endotracheal tube intracuff pressure (ETTICP) results in the micro-aspiration of the contents of the mouth, larynx, and stomach,[10,14] especially during inhalation,[10,15] which is a significant contributor to pneumonia caused by the ventilator.[10,14]. The risk of this complication increases by up to four times due to the pressure of less than 20 cmH2O.16. The insufficient endotracheal tube intracuff pressure (ETTICP) results in the micro-aspiration of the contents of the mouth, larynx, and stomach,[10,14] especially during inhalation,[10,15] which is a significant contributor to pneumonia caused by the ventilator.[10,14] The risk of this complication increases by up to four times due to the pressure of less than 20 cmH2O.16 the inadequate ETTICP leads to insufficient delivery of the determined vital capacity to the patient.[11]
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