Outcome of Conventional Method for Achieving Standard Endotracheal Cuff Pressure in Patients undergoing Endotracheal Intubation

Shahzada Irfan; Mubeen Ikram; Hassan Nasir Minhas; Sami Wahid; Bilal Humayyun Khan Durrani; Mirza Hamid Beg; Asad Saeed

doi:10.51253/pafmj.v76i2.10999

Authors

Shahzada Irfan Department of Anesthesia, Combined Military Hospital Kharian/National University of Medical Sciences (NUMS) Pakistan
Mubeen Ikram Department of Anesthesia, Combined Military Hospital Kharian/National University of Medical Sciences (NUMS) Pakistan
Hassan Nasir Minhas Department of Anesthesia, Combined Military Hospital Kharian/National University of Medical Sciences (NUMS) Pakistan
Sami Wahid Department of Anesthesia, Combined Military Hospital Kharian/National University of Medical Sciences (NUMS) Pakistan
Bilal Humayyun Khan Durrani Department of Anesthesia, Combined Military Hospital Kharian/National University of Medical Sciences (NUMS) Pakistan
Mirza Hamid Beg Department of Anesthesia, Combined Military Hospital Kharian/National University of Medical Sciences (NUMS) Pakistan
Asad Saeed Department of Medicine, Combined Military Hospital Nowshera/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i2.10999

Keywords:

Cuff Pressure, Endotracheal Intubation, Endotracheal Tube, Manometer

Abstract

Objective: To measure endotracheal cuff pressure by conventional versus instrumental method in patients undergoing endotracheal intubation

Study Design: Prospective longitudinal study.

Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Kharian Pakistan, Jan to Jul 2023

Methodology: Patients undergoing elective surgery under general anesthesia were included in the study. Endotracheal (ETT) cuff inflation was done using the conventional syringe method, a 10 ml syringe in Group-A and a 20 ml syringe in Group-B after intubation. Patients with difficult intubation, high risk of aspiration, facial trauma, anatomical laryngotracheal abnormality, and emergency cases were excluded. Cuff pressure was measured using an aneroid manometer, adjusted, and compared in both groups. ETT cuff pressure of 20-30cm of H2O was taken as normal.

Results: Two hundred and twenty patients undergoing elective surgery under general anesthesia were included, with 122(55.4%) males and 98(44.5%) females, and a mean age of 46.22±10.38 years. There was no statistical difference in gender, BMI, and ASA class among participants of both groups in which the ETT cuff was inflated using a 10ml or 20ml syringe. The mean baseline ETT cuff pressure was 35.45±3.10 cm of H2O. 96(87.3%) participants in the 10ml syringe group and 109(99.1%) participants in the 20ml syringe group had cuff pressure >30 cm of H2O (p<0.05) Positive correlation was found between cuff pressure and syringe size (Pearson coefficient; +0.401, p<0.005).

Conclusion: ETT cuff inflation by conventional syringe method is unreliable and can be harmful. Instrumental cuff inflation and pressure monitoring are suggested for more accurate pressure.

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