Comparison of Methods of Non-Mechanical Pressure Measurement in the Cuff of an Endotracheal Tube

Abstract

Background: Tracheal injuries are uncommon but pose significant risks in anesthesiology and critical care. These injuries primarily occur due to the direct mechanical impact, often linked to the excessive pressure from the intubation tube's cuff. This study aims to assess the actual cuff pressure in intubated patients during surgeries, examine how these measurements correlate with anesthesiologists' subjective evaluations, and compare various cuff inflation techniques. Methods: The study included 90 patients, divided into two groups of 45 each. For the experimental group, the cuff was inflated using the «minimum leakage» method, while the control group used palpation to gauge the required pressure. The actual cuff pressure for both groups was determined using a mechanical manometer connected to the cuff. Results: The mean pressure in the experimental group was 30.4 ± 4.9 cm H2 O (2.98 ± 0.48 kPa), significantly lower than the control group's 68.9 ± 23.3 cm H2 O (6.75 ± 2.28 kPa). In the control group, only 2 patients were within the safe pressure range, compared to 23 in the experimental group. Conclusion: The palpation method for estimating cuff pressure in intubated patients often does not reflect the actual pressure values. The study highlights the effectiveness of the minimal occlusion volume technique as a non-mechanical method for more accurately measuring and controlling cuff pressure.