Identification of a Very High Cuff Pressure by Manual Palpation of the External Cuff Balloon on an Endotracheal Tube

AANA J. 2015 Jun;83(3):179-82.

Abstract

The most common complication due to intubation is a high cuff pressure. A high cuff pressure can cause postanesthetic tracheal mucosal injuries in patients undergoing surgery. The aim of this cross-sectional study was to describe whether anesthetic nurses and anesthesiologists identified a very high cuff pressure by manual palpation of the external cuff balloon on an endotracheal tube. An airway device was intubated with an endotracheal tube cuffed to 95 cm H2O. Each participant palpated the external cuff balloon and then filled out a questionnaire, including estimation of the cuff pressure and user frequency of the cuff pressure manometer. The results showed that 89.1% estimated that the cuff pressure was high. Among the participants who rated the cuff pressure as high, 44.8% rated the pressure as quite high and 60.6% rated the pressure as very high. There was no significant relationship between profession and skill in identifying a very high cuff pressure (P = .843) or between work experience and skill in terms of identifying a very high cuff pressure (P = .816). These findings indicate that 10% of patients are at risk of tracheal erosion because of a high cuff pressure.

MeSH terms

  • Adult
  • Anesthesia / methods
  • Anesthesia / nursing*
  • Clinical Competence
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intubation, Intratracheal / adverse effects*
  • Male
  • Manometry*
  • Middle Aged
  • Monitoring, Intraoperative / methods*
  • Nurse Anesthetists
  • Operating Room Technicians
  • Pressure / adverse effects*
  • Trachea / injuries*
  • Wounds, Nonpenetrating / etiology
  • Wounds, Nonpenetrating / prevention & control*