BackgroundCuff pressure in endotracheal (ET) tubes should be in the range of 20–30 cm H2O. We tested the hypothesis that the tube cuff is inadequately inflated when manometers are not used.MethodsWith IRB approval, we studied 93 patients under general anesthesia with an ET tube in place in one teaching and two private hospitals. Anesthetists were blinded to study purpose. Cuff pressure in tube sizes 7.0 to 8.5 mm was evaluated 60 min after induction of general anesthesia using a manometer connected to the cuff pilot balloon. Nitrous oxide was disallowed. After deflating the cuff, we reinflated it in 0.5-ml increments until pressure was 20 cmH2O.ResultsNeither patient morphometrics, institution, experience of anesthesia provider, nor tube size influenced measured cuff pressure (35.3 ± 21.6 cmH2O). Only 27% of pressures were within 20–30 cmH2O; 27% exceeded 40 cmH2O. Although it varied considerably, the amount of air required to achieve a cuff pressure of 20 cmH2O was similar with each tube size.ConclusionWe recommend that ET cuff pressure be set and monitored with a manometer.

Objective To characterize differences in health-related quality of life among women presenting for treatment of fecal incontinence. Methods Among 155 women presenting for treatment of fecal incontinence in a specialty clinic, validated questionnaires measured impact on quality of life (Modified Manchester Health Questionnaire) and severity (the Fecal Incontinence Severity Index). Bowel symptoms, including frequency, urgency, and stool consistency, were ascertained. Co-morbid diseases were self-reported. Linear regression models were constructed from significant univariate variables to examine differences seen in quality of life scores. Results Average age was 58.7 ± 11.5 with no differences found in quality of life scores according to race, body mass index, or number of vaginal deliveries (p > 0.05). Younger age, increased urinary incontinence symptoms, prior cholecystectomy, prior hysterectomy, and severity of bowel symptoms correlated with a negative impact on quality of life in univariate analysis (p <0.05). Average severity scores were 30.5 ± 13.7 with moderate correlation seen with increasing severity and quality of life scores (R2= 0.60). After controlling for severity, women had increased quality of life scores with more bowel urgency (15 points, 95% CI 8.1, 21.2), harder stool consistency (10 points, 95% CI 3.8, 16.3), and prior hysterectomy (9 points, 95% CI 2.7, 15.4). Conclusion Bowel symptoms and having a prior hysterectomy had the greatest negative impact on quality of life in women seeking treatment for fecal incontinence. Targeting individualized treatments to improve bowel symptoms may improve quality of life for women with fecal incontinence.