Endotracheal tube cuff pressure: need for precise measurement

Bráz, José Reinaldo Cerqueira; Navarro, Laís Helena Camacho; Takata, Ieda Harumi; Nascimento, Paulo do

doi:10.1590/s1516-31801999000600004

Cited by 94 publications

(120 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…More than fifty percent of ICU patients had reported pressures >30mmHg. 3 Wujtewicz et al found in an audit done on 107 ITU patients monitoring tracheal tube cuff pressure, that the over inflation is more frequent than under inflation in their study group. 4 An audit done in the department of anaesthesia, the Queen Elizabeth Hospital, King's Lynn, UK showed that the mean cuff pressure in the study group was 62 cmH2O and 20% of the CPs were above 100 cmH2O.…”

Section: Discussionmentioning

confidence: 84%

Endotracheal tube cuff pressure management in adult critical care units in the National Hospital of Sri Lanka ; A baseline audit

Maddumage

Gunasekara²,

Priyankara

2017

Sri Lankan J Anaesthesiol

View full text Add to dashboard Cite

Proper management of endotracheal cuff pressure is pivotal, not only to prevent complications like tracheal mucosal damage and micro aspirations but for efficient positive pressure ventilation. A prospective descriptive study was performed to examine the prevailing practices of endotracheal cuff pressure management (CPM) in adult intensive care units (ICUs) of the National Hospital of Sri Lanka. The auditors visited the ICUs without a prior warning and the CPM was assessed and the endotracheal cuff pressure (CP) was measured using an analogue manometer. Seventy four percent out of total of 50 patients examined had suboptimal cuff pressure recordings and 30% of them had alarmingly high pressures. Overall practice including documentation (14%), frequency (14%) and the method of CPM (20%) was significantly unsatisfactory warranting prompt measures to uplift the standards and prevent adverse consequences.

show abstract

Section: Discussionmentioning

confidence: 84%

Endotracheal tube cuff pressure management in adult critical care units in the National Hospital of Sri Lanka ; A baseline audit

Maddumage

Gunasekara²,

Priyankara

2017

Sri Lankan J Anaesthesiol

View full text Add to dashboard Cite

show abstract

“…Accordingly, during anesthesia with N 2 O, cuff pressure measurements and adjustment of cuff pressure should be considered, due to the high intracuff pressures attained. 1,2 As N 2 O diffuses more rapidly into the cuff than nitrogen diffuses out, augmentation of cuff pressure occurs, a well-known phenomenon. 1,6,7 This tendency is opposed by barometric pressure build up in the cuff.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Tracheal arterial capillary pressure decreases when the cuff exerts pressure greater than 30 cm H 2 O, causing tracheal ischemia proportional to the pressure exerted by the cuff and the time of exposure. 3 An ETT with the Lanz® pressure regulating valve, which has a large pilot balloon, effectively limits to 30 cm H 2 O the increase in cuff pressure caused by excessive volume inflated in the pilot balloon, or N 2 O diffusion into the ETT cuff.…”

mentioning

confidence: 99%

Ľusage du tube endotrachéal Lanz® réduit les lésions de la trachée chez les chiens

Abud

Bráz

Martins

et al. 2005

Can J Anesth/J Can Anesth

Self Cite

View full text Add to dashboard Cite

Purpose: To determine, in dogs anesthetized with nitrous oxide (N 2 O), whether the endotracheal tube (ETT) cuffed with a Lanz® pressure regulating valve decreases the tracheal consequences of tracheal intubation. Methods:Sixteen mixed-breed dogs were allocated to two groups according to the ETT used: Control group (n = 8) -Rüsch ETT, and Lanz group (n = 8) -ETT with Lanz® pressure regulating valve. The ETT cuffs in both groups were inflated with air to an intracuff pressure of 30 cm H 2 O. Anesthesia was induced and maintained with pentobarbitone and N 2 O (1.5 L·min -1 ) and O 2 (1 L·min -1 ). ETT cuff pressures were measured before (control) and 60, 120, and 180 min during N 2 O administration. The dogs were sacrificed, and biopsy specimens from four predetermined areas of the tracheal mucosa in contact with the ETT were collected for light and scanning electron microscopy (SM) examination.Results: Cuff pressures in the Control group were higher than in the Lanz group at all time points studied (P < 0.001), with an increase over time only in the Control group (P < 0.001). Median neutrophilic inflammatory infiltration values of the epithelial surface, and in the subepithelial layer in contact with the cuff, were higher in the Control group as compared to the Lanz group (3.0 vs 1.0 and 3.0 vs 1.5 respectively) (P < 0.05). On SM examination, median histological grades were higher in the Control group compared to Lanz group (2.9 vs 1.9 respectively), (P < 0.05). Conclusions

show abstract

“…O que se observa na rotina hospitalar é que a mensuração da pressão intracuff é, por vezes, negligenciada pelos profissionais da equipe [7,8,42]. Quando a verificação é realizada, geralmente, ocorre pela palpação digital do balonete externo, sendo esta insuficiente e inadequada para detectar alterações da pressão e, portanto, não fidedigna [17,32].…”

Section: Introductionunclassified

“…Quando a verificação é realizada, geralmente, ocorre pela palpação digital do balonete externo, sendo esta insuficiente e inadequada para detectar alterações da pressão e, portanto, não fidedigna [17,32]. Portanto, faz-se necessária a mensuração da pressão por meio de métodos considerados mais seguros e confiáveis, utilizando um equipamento adequado como o cuffômetro, ou ainda, o manômetro de pressão acoplado a dispositivos de adaptação [7,8,21,42], o qual pode ser utilizado nos casos em que não são disponibilizados os equipamentos convencionais.…”

Section: Introductionunclassified

Intervenção educacional relacionada à rotina de mensuração do balonete endotraqueal em um hospital universitário

Carvalho

Oliveira

2013

Rev. Cult. Ext. USP

View full text Add to dashboard Cite

O suporte ventilatório mecânico invasivo promove benefícios. Entretanto, procedimentos que envolvem sua instituição podem gerar lesões em graus variáveis. A pressão do balonete que envolve o tubo traqueal, impedindo escape aéreo, não deve exceder à pressão de perfusão traqueal nem estar reduzida, a ponto de permitir a passagem de micro-organismos, ocasionando lesões teciduais e pneumonia aspirativa, respectivamente. A vigilância desta pressão como rotina de prevenção de complicações não é realizada em diversas unidades de tratamento intensivo. Assim, enfatizar estratégias preventivas parece ser um modo razoável de minimizá-las. A intervenção educacional objetiva difundir o conhecimento e valorizar aspectos importantes para melhoria da qualidade da assistência em saúde e promover redução das taxas de reintubação, tempo de internação hospitalar, morbi-mortalidade e custos hospitalares. O objetivo foi o de promover uma ação educacional, por meio da divulgação de instrumento informativo não verbal, no ambiente hospitalar. Valores obtidos dentro da faixa de normalidade esperada das pressões de cuff sofreram acréscimo de 11,36% para 20,51% após a intervenção. Assim, o modelo de intervenção educacional atingiu o objetivo esperado, embora seja recomendado e desejável que outras intervenções estejam futuramente associadas, visando complementar e enfatizar a importância da técnica para que haja benefícios mais expressivos neste âmbito.Palavras-chave: Balonete endotraqueal. Intervenção educacional. Equipe multiprofissional. A B S T R A C TThe invasive mechanical ventilation support promotes clear benefits. However, procedures involved in its institution can generate lesions in varying degrees. The cuff pressure surrounding the tracheal tube prevents air leakage and should not exceed tracheal perfusion pressure and should not be reduced also, allowing the passage of

show abstract

Endotracheal tube cuff pressure: need for precise measurement

Abstract: Endotracheal tubes cuff pressures in ICU and PACU are routinely high and significant higher when nitrous oxide is used. Endotracheal tubes cuff pressure should be routinely measured to minimize tracheal trauma.

Cited by 94 publications

References 14 publications

Endotracheal tube cuff pressure management in adult critical care units in the National Hospital of Sri Lanka ; A baseline audit

Endotracheal tube cuff pressure management in adult critical care units in the National Hospital of Sri Lanka ; A baseline audit

Ľusage du tube endotrachéal Lanz® réduit les lésions de la trachée chez les chiens

Intervenção educacional relacionada à rotina de mensuração do balonete endotraqueal em um hospital universitário

Contact Info

Product

Resources

About