The Effect of Endotracheal Tube Cuff Shape on Post-extubation Sore Throat in Critically Ill Patients in a Rural Tertiary Care Hospital.

Abstract

Patients admitted to the critical care unit often require extended periods of mechanical ventilation. After extubation, patients often report discomfort in their throats, coughing, and hoarseness of voice. These symptoms have been linked to the shape of the cuff on the endotracheal tube and are described in terms of the surface area of the cuff in contact with the trachea. During this pilot study, 160 adults receiving intensive primary care were randomly assigned to one of two groups (Gathering A or Gathering B; 80 patients each). Intubated patients were separated into two groups: Group C consisted of those who wore a looser, barrel-shaped sleeve, and Group T consisted of those who wore a more restrictive sleeve. The severity of post-extubation side effects was assessed, including sore throat, dry voice, and hack, and the occurrence of these symptoms was also documented. Neither the number of intubation attempts nor the experience level of the residents who performed them differed significantly between the two groups (p > 0.05). A smaller percentage of patients in Gathering T experienced sore throats in the first, 12th, and 24th hours after extubation compared to patients in Group C at these same time points (p = 0.05). With time passing, fewer people in Group C and Group T experienced hoarseness of voice after extubation. There is a declining trend in the incidence of cough post-extubation in Group T, as compared to an initial increase in the trend for cough post-extubation with a gradual decline as time progressed in Group C. There is an overall decrease in the incidence of post-extubation emergence phenomena with tapered shape cuffed endotracheal tubes when compared with conventional cylindrical type cuffed endotracheal tubes.