Endotracheal Tube Cuff Pressure in Patients Admitted to Intensive Care Units After Cardiac Surgery

Abstract

<strong><em>Background:</em></strong> The endotracheal tube (ETT) cuff pressure must be kept within the range of 20 to 30 cmH₂O in order to prevent tube displacement and air leakage, maintain the circulation of the tracheal capillaries, and prevent the aspiration of oral and gastric contents to the lower parts of the respiratory tract. This study aimed to determine the ETT cuff pressure and appropriate intervals for measuring it in patients admitted to intensive care units (ICUs).

<strong><em>Methods:</em></strong> This descriptive cross-sectional study was conducted on 100 patients after cardiac surgery with general anesthesia admitted to ICUs between May and November 2017. For each research unit, the ETT cuff pressure was measured twice at a 6-hour interval using a cuff pressure manometer. Descriptive (ie, mean, standard deviation, and frequency distribution) and inferential (ie,<em> t</em>-test, Pearson, and ANOVA) statistics were used to describe the data. All the ETT cuff pressure measurements were performed with a calibrated manometer. The data were analyzed using the SPSS software, version 22.0.

<strong><em>Results:</em></strong> The mean ETT cuff pressure was 38.3 ± 24.9 cmH₂O. In the first measurement, the ETT cuff pressure was normal in only 17% of the subjects, while this figure increased to 78% after the 6-hour control period and cuff-pressure correction. There was a significant relationship between the number of days of intubation and the ETT cuff pressure in both first (<em>P</em> = 0.003) and second (<em>P</em> = 0.01) measurements.

<strong><em>Conclusions:</em></strong> The ETT cuff pressure often exceeds the recommended normal range, which can serve as a reminder that it may be necessary to control it at shorter intervals to avoid complications caused by increases or decreases in the cuff pressure. <strong><em>(Iranian Heart Journal 2020; 21(3): 33-39)</em></strong>