Evaluation of High Volume, Low Pressure Endotracheal Tube Cuff Pressure
Abstract
Background : Inappropriated intracuff pressure (underpressure of overpressure) is the main cause of respiratory complications in intubated patients with mechanical ventilation such as aspiration, tidal volume leakage, tracheal ischemia, necrosis and stenosis etc. Subjective assessment by doctors or nurses that has very low reliability is the cause of inappropriated intracuff pressure
Objective : to assess the efficiency of high volume, low pressure end tracheal tube cuff ressure measurement by subjective assessment.
Design : A descriptive study.
Setting : At Srinagarind hospital, faculty of Medicine, Khon Kaen university.
Subjects : The study was completely done in 105 cases (54 male and 51 female patients) of intubated patients with mechanical ventilation at different wards (Surgery, medicine, ICU and Emergency)
Measurements : Intracuff pressure was measured with fluid-filled quartz transducer (HP 1290 C) and Hewlett Packard Monitor (78354 C, Made in USA.) and then recorded in mmHg
Results : It was found that intracuff pressure was appropriated in only 13.33% (normal range 20-25 mmHg) in all wards (Surgery 6.67%, Medicine 17.86%, ICU 13.64% and Emergency 11.11%) The rate of inappropriated intracuff pressure was 86.66% (underpressure 44.76% and overpressure 41.90%). There was no statistical significance in intracuff pressure assessment among patients from different wards.
Conclusion : Endotracheal tube cuff inflation by subjective assessment was not accurate and unreliable. The use of objective systems for intracuff pressure measurement is useful, highly accurate and more reliable and should be routinely implemented. It can prevent or reduce respiratory complications if use as a routine practive and follow up every 1-2 hours in all intubatd patients.
Key words : High volume, low pressure endotracheal tube cuff, intracuff pressure
