Endotracheal Tube Cuff Pressure Following Intubation

Abstract : An endotracheal tube (ETT) is frequently necessary for airway management. Proper inflation of the ETT cuff is critical for patient safety. Pressure must be high enough to seal the trachea to prevent aspiration of regurgitated stomach contents and avoid air leaks to the atmosphere, yet low enough to allow adequate perfusion of the tracheal mucosa. This study explored the anesthesia provider's ability to correctly determine ETT cuff pressure using a qualitative estimation (i.e., finger palpation of the ETT pilot balloon) compared to a quantitative measurement (manometer). The hypothesis was that there would be a difference between the two assessments. After patient intubation, an anesthesia provider inflated the ETT cuff to its estimated appropriate pressure by finger palpation of the pilot balloon. A researcher then obtained a quantitative measurement of the actual pressure using a manometer. Data were obtained from 50 patients and the qualitative and quantitative measurements were compared. Overall, 72 percent of the cuff pressures were incorrectly estimated by finger palpation (26% were too low and 46% were too high). Findings confirm that the qualitative method of ETT cuff pressure measurement is both a less precise and inconsistent means for determining actual pressure than is quantitative measurement and may compromise patient safety.