High intraoperative cuff pressure incidence due to endotracheal cuff inflation methods and its clinical effects

Abstract

Objective: The most important function of the endotracheal tube cuff is that it does not cause leakage during positive pressure ventilation and prevents aspiration of pharyngeal content. endotracheal tube cuff. Different methods are used for inflating cuffs. The aim of this study is to check whether these methods provide safe measurement values and to review the awareness about this issue. Method: After approval of the local ethics committee was obtained, 249 patients in the ASA I-IV risk group were included. Routine induction and maintenance of anesthesia was applied for patients undergoing routine anesthesia monitoring. Demographic data, tube number, cuff pilot inflation method and the individuals who inflated the cuffs were recorded. After 15 minutes, the cuff pressure was measured with the manometer and recorded. High pressures were lowered to the normal range without causing leakage. Complications in the recovery room and at the 24th hour as for sore throat, hoarseness and dysphagia were recorded. Results: A total of 249 patients were included in this study. None of the patients had cuff pressures below the acceptable safe limit of 20 cmH2O. Patients were divided into four groups according to cuff pressures: Group N (20-30 cmH2O), group I (30-50 cmH2O), Group II (50-70 cmH2O) and Group III (>70 cmH2O). Eighteen (7.2%) patients were in Group N, 105 (42.1%) were in Group I, 50 (20%) were in Group II, 76 patients (30.5%) were in Group III with the highest cuff pressure. Palpation method was used in 78% of the patients (p<0.001). Postoperative sore throat occurred in 8 patients (3.2%) in the recovery room and 78 (31.3%) patients at 24.hr after operation. All of 8 patients who had sore throat in the recovery room were in Group III with the highest cuff pressure (p<0.001). Sore throat at 24 hours was especially correlated with elevated cuff pressure and 61 (80.2%) of 76 patients had positive cuff pressure (p<0.001). Conclusion: With this study, we have seen that the pressure of the endotracheal tube cuff cannot be adjusted by the routine methods which we use (palpation and minimum leak volume methods) and mostly cause high pressures. We also found that these high pressures are associated with postoperative sore throat.