Assessment Of Endotracheal Tube Cuff Pressure Among Intubated Patients In Emergency Department, Operating Rooms, And Icus

Abstract

Background: Tracheal intubation constitutes a routine part of anesthetic practice both in the operating theatre as well as in the care of critically ill patients. Maintain the Endotracheal Tube Cuff Pressure (ETCP) within safe ranges, which ensures airway patency and provides positive pressure ventilation, is a complex circumstance due to many factors. Although there are recommendations for the prevention of excessive or insufficient ETCP, there is still no consensus based on affecting factors. Establishing and maintaining a secure airway using a cuffed endotracheal tube (E[1]TT) is an important step in management of intubated patients. Out-of-range ETT cuff pressure is associated with various complications which could lengthen the hospital stay. The study aims: To evaluate ETT cuff pressure in intubated patients in the emergency department (ED), operating rooms (ORs), and Intensive Care Units (ICUs). Methods: A cross-sectional study was conducted among intubated patients admitted to ED, ICUs, and ORs of Hospital, Jeddah, KSA from January to July 2022. The ETT cuff pressure of 153 patients was measured using a standard manometer. Demographic data and duration of intubation were recorded. The data were analyzed using the SPSS software version 28. P values less than 0.05 were considered significant. Results: The ETT cuff pressure exceeded the recommended range in 125 out of 153 patients (81.7%). The mean cuff pressure (67.29 cmH2O) was significantly higher than the recommended range (p<0.001). The cuff pressure was higher in patients in the ORs compared to patients in the ED and ICU (OR=8.46, p<0.001). Conclusion: Intubation in the OR can be considered a risk factor for higher-than- normal ETT cuff pressure and subsequent complications. The ETT cuff pressure monitoring by means of a manometer is recommended.