Is sealing cuff pressure, easy, reliable and safe technique for endotracheal tube cuff inflation?: A comparative study

Al-Metwalli, Roshdi R.; Al-Ghamdi, Abdulmohsen A.; Mowafi, Hany A.; Sadek, S. A. A.; Abdulshafi, Mohammed; Mousa, Wesam F.

doi:10.4103/1658-354x.82795

Cited by 30 publications

(29 citation statements)

References 16 publications

(20 reference statements)

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“…[2][3][4][5] Using this technique, we can slowly inflate the cuff until the air leak stops during the inspiratory phase of positive-pressure ventilation. 12 Documentation has suggested that the MOV technique can be an inaccurate method for promoting adequate cuff inflation because it might result in overinflated cuff pressure to seal the airway. 3 Studies have shown that increased cuff pressure can contribute to the development of tracheal mucosa injuries, sore throat, and coughing episodes after endotracheal intubation.…”

Section: Discussionmentioning

confidence: 99%

Clinical Use of the Volume-Time Curve for Endotracheal Tube Cuff Management

Gomes

et al. 2014

Respir Care

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BACKGROUND: Previous investigation showed that the volume-time curve technique could be an alternative for endotracheal tube (ETT) cuff management. However, the clinical impact of the volume-time curve application has not been documented. The purpose of this study was to compare the occurrence and intensity of a sore throat, cough, thoracic pain, and pulmonary function between these 2 techniques for ETT cuff management: volume-time curve technique versus minimal occlusive volume (MOV) technique after coronary artery bypass grafting. METHODS: A total of 450 subjects were randomized into 2 groups for cuff management after intubation: MOV group (n ‫؍‬ 222) and volume-time curve group (n ‫؍‬ 228). We measured cuff pressure before extubation. We performed spirometry 24 h before and after surgery. We graded sore throat and cough according to a 4-point scale at 1, 24, 72, and 120 h after extubation and assessed thoracic pain at 24 h after extubation and quantified the level of pain by a 10-point scale. RESULTS: The volume-time curve group presented significantly lower cuff pressure (30.9 ؎ 2.8 vs 37.7 ؎ 3.4 cm H 2 O), less incidence and intensity of sore throat (1 h, 23.7 vs 51.4%; and 24 h, 18.9 vs 40.5%, P < .001), cough (1 h, 19.3 vs 48.6%; and 24 h, 18.4 vs 42.3%, P < .001), thoracic pain (5.2 ؎ 1.8 vs 7.1 ؎ 1.7), better preservation of FVC (49.5 ؎ 9.9 vs 41.8 ؎ 12.9%, P ‫؍‬ .005), and FEV 1 (46.6 ؎ 1.8 vs 38.6 ؎ 1.4%, P ‫؍‬ .005) compared with the MOV group. CONCLUSIONS: The subjects who received the volumetime curve technique for ETT cuff management presented a significantly lower incidence and severity of sore throat and cough, less thoracic pain, and minimally impaired pulmonary function than those subjects who received the MOV technique during the first 24 h after coronary artery bypass grafting.

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Section: Discussionmentioning

confidence: 99%

Clinical Use of the Volume-Time Curve for Endotracheal Tube Cuff Management

Gomes

et al. 2014

Respir Care

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“…Among the three trials, two were conducted in Asian (11,13), and one in south America (12). All trials were published in English.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…Three trials with a total of 609 patients were identified and finally included into the current analysis (11)(12)(13). The Cohen К statistic for agreement on study inclusion was 0.92.…”

Section: Identification and Selection Of Studymentioning

confidence: 99%

Impact of Endotracheal Tube Cuff Pressure on Postoperative Sore Throat: A Systematic Review and Meta-Analysis

Hu¹,

Xu²,

Zhao³

et al. 2016

J Anesth Perioper Med

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“…[3][4][5] However, with this technique it is not easy to precisely determine when to stop inflating, which means that high or insufficient CP can seal the airway. 6,7 Despite numerous studies [3][4][5][6][7][8][9][10] documenting the importance of the assessment and the maintenance of the CP within an appropriate range, an easy application technique has yet to be described that is capable of calibrating the volume of air to be injected into the cuff in a less subjective form while maintaining a low CP.…”

Section: Introductionmentioning

confidence: 99%

Volume-Time Curve: An Alternative for Endotracheal Tube Cuff Management

Gomes

Faresin

et al. 2012

Respir Care

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BACKGROUND: Despite numerous studies on endotracheal tube cuff pressure (CP) management, the literature has yet to establish a technique capable of adequately filling the cuff with an appropriate volume of air while generating low CP in a less subjective way. The purpose of this prospective study was to evaluate and compare the CP levels and air volume required to fill the endotracheal tubes cuff using 2 different techniques (volume-time curve versus minimal occlusive volume) in the immediate postoperative period after coronary artery bypass grafting. METHODS: A total of 267 subjects were analyzed. After the surgery, the lungs were ventilated using pressure controlled continuous mandatory ventilation, and the same ventilatory parameters were adjusted. Upon arrival in the ICU, the cuff was completely deflated and re-inflated, and at this point the volume of air to fill the cuff was adjusted using one of 2 randomly selected techniques: volume-time curve and minimal occlusive volume. We measured the volume of air injected into the cuff, the CP, and the expired tidal volume of the mechanical ventilation after the application of each technique. RESULTS: The volume-time curve technique demonstrated a significantly lower CP and a lower volume of air injected into the cuff, compared to the minimal occlusive volume technique (P < .001). No significant difference was observed in the expired tidal volume between the 2 techniques (P ‫؍‬ .052). However, when the subjects were submitted to the minimal occlusive volume technique, 17% (n ‫؍‬ 47) experienced air leakage as observed by the volume-time graph. CONCLUSIONS: The volume-time curve technique was associated with a lower CP and a lower volume of air injected into the cuff, when compared to the minimal occlusive volume technique in the immediate postoperative period after coronary artery bypass grafting. Therefore, the volume-time curve may be a more reliable alternative for endotracheal tube cuff management.

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Is sealing cuff pressure, easy, reliable and safe technique for endotracheal tube cuff inflation?: A comparative study

Cited by 30 publications

References 16 publications

Clinical Use of the Volume-Time Curve for Endotracheal Tube Cuff Management

Clinical Use of the Volume-Time Curve for Endotracheal Tube Cuff Management

Impact of Endotracheal Tube Cuff Pressure on Postoperative Sore Throat: A Systematic Review and Meta-Analysis

Volume-Time Curve: An Alternative for Endotracheal Tube Cuff Management

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