Endotracheal tube cuff pressure control during anesthesia in cancer patients

Abstract

Relevance: An endotracheal tube (ETT) cuff provides a seal and encloses the lower airway from aspiration. Normally, the pressure in the
ETT cuff is in the range of 20 to 30 cm of the water column. Both increased and insufficient inflation of the ETT cuff is associated with a number of complications.
The study aimed to compare palpation and apparatus methods of pressure control in the cuff of the endotracheal tube during anesthesia in cancer patients.
Methods: A prospective observational study included 60 patients during general anesthesia in the department of anesthesiology and intensive care of KazIOR. Air was injected into the ETT cuff using a syringe, followed by palpation of the ETT cuff balloon and pressure control using the IntelliCuff device (Hamilton Medical, Switzerland). The actual pressure was compared with normal values, then the air volume, actual and necessary to achieve normal pressure, was estimated.
Results: assessment of the pressure level by the “classic” palpation method led to errors in the pressure level in the ETT cuff in more than 50% of cases; the normal level of pressure was only in 25 patients (42%), while the measured air volume in the cuff was on average 5.9±1.9 ml, although for the average air volume to achieve a pressure of 25 mm of water column was 3.9 ml, which led to an overestimated level of pressure in the ETT cuff.
Conclusion: Determining ETT cuff pressure by palpation of the control balloon, while common practice, often results in incorrect pressure readings. At the same time, both high and low pressure in the ETT cuff is associated with the development of complications. The use of devices for measuring pressure in the ETT cuff allows you to control its level, while devices that allow prolonged monitoring of pressure in the ETT cuff have an advantage.