Achieving the Recommended Endotracheal Tube Cuff Pressure: A Randomized Control Study Comparing Loss of Resistance Syringe to Pilot Balloon Palpation

Anesthesiology Research and Practice
Fred BulambaArthur Kwizera

Abstract

Both under- and overinflation of endotracheal tube cuffs can result in significant harm to the patient. The optimal technique for establishing and maintaining safe cuff pressures (20-30 cmH2O) is the cuff pressure manometer, but this is not widely available, especially in resource-limited settings where its use is limited by cost of acquisition and maintenance. Therefore, anesthesia providers commonly rely on subjective methods to estimate safe endotracheal cuff pressure. This study set out to determine the efficacy of the loss of resistance syringe method at estimating endotracheal cuff pressures. This was a randomized clinical trial. We enrolled adult patients scheduled to undergo general anesthesia for elective surgery at Mulago Hospital, Uganda. Study participants were randomized to have their endotracheal cuff pressures estimated by either loss of resistance syringe or pilot balloon palpation. The pressures measured were recorded. One hundred seventy-eight patients were analyzed. 66.3% (59/89) of patients in the loss of resistance group had cuff pressures in the recommended range compared with 22.5% (20/89) from the pilot balloon palpation method. This was statistically significant. The loss of resistance syringe method wa...Continue Reading

References

Nov 1, 1992·Acta Anaesthesiologica Scandinavica·N Lomholt
Feb 1, 1990·Anesthesia and Analgesia·E Resnikoff, J A Katz
Jul 1, 1996·American Journal of Respiratory and Critical Care Medicine·J RelloJ Vallés
May 17, 2005·European Journal of Anaesthesiology·P BiroT Pasch
Mar 3, 2011·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Mary Lou SoleMelody Bennett
Mar 9, 2011·South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde·Christopher SteinEfraim Kramer
May 1, 2009·Korean journal of anesthesiology·Jin HuhDuk Kyung Kim

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Citations

Aug 30, 2019·Journal of Feline Medicine and Surgery·Donna M WhiteFernando Martinez-Taboada
Dec 8, 2020·Journal of the Mechanical Behavior of Biomedical Materials·David BerardDavid Restrepo

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Clinical Trials Mentioned

NCT02294422

Software Mentioned

STATA
EpiData

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