Endotracheal Tube Cuff Inflation Pressure awareness and response to education among anesthesia technicians

Abstract

Objective: Cuffed endotracheal tubes are used to ensure ventilator compliance and prevent pulmonary aspiration in mechanically ventilated patients. At cuff pressures greater than 40 cmH2O, mucosal irritation, ulceration, hemorrhage, tracheal stenosis, and tracheoesophageal fistula can occur due to increased perfusion pressure of the tracheal mucosa and submucosa. In this study, we compare the awareness of cuff pressure among anesthesia technicians working in the operating room. Materials and Methods: All anesthesia technicians received a seminar on cuff pressure. An attempt was made to determine the difference between cuff pressures measured before and after the seminar. Results: A positive correlation was found when the cuff pressure measurement was compared with the first measurement after the training (Cor. Coef.= 0.376). At the first measurement, the mean cuff pressure was 82 cmH20, the lowest pressure was 27, and the highest was 223. At the measurement after completion of the training, the mean pressure was 50, the lowest pressure was 26, and the highest pressure was 105. The difference between the two measurements was statistically significant (p=0.000). Before training, only four technicians (7.40%) inflated below the recommended confidence interval (30 cm H2O), while the remaining 50 technicians (92.6%) inflated above this limit. After training, 11 technicians could inflate below the confidence interval. A statistically significant increase was observed (p < 0.05). Conclusion: Measuring the cuff pressure of the endotracheal tube was essential to avoid possible complications. Educational seminars on this topic and the provision of cuff meters can avoid these problems.