Comparison of tracheal tube cuff inflation pressure among anesthesia team with different gradual level

Tracheal intubation is frequently performed in operating room. Over inflation of the endotracheal tube cuff is a risk factor for tracheal ischemia and subsequent complications. On the other hand inadequate cuff pressure increases the risk of aspiration of gastric contents. In this study, the endotracheal tube cuff pressure filled by the anesthesia team has been compared.

In this cross-sectional study, we assessed the tracheal tube cuff inflation pressure among 80 anesthesiologists, nurses of anesthesia, and anesthesiology assistants using a manometer. High-volume, low-pressure tubes were used for intubation in all patients. The anesthesiologists and other personnel were not informed of the planned study.

The average pressure generated by inflating the endotracheal tube cuff among anesthesiologists and senior anesthesia assistants, junior nurses with 1 to 15 years of experience in anesthesia, senior nurses with 15-30 years of experience in anesthesia and, junior anesthesia assistants were 49.24±24, 70.8±29, 56.8±20 and 73.5±29 mmHg, respectively.

There is a tendency to over inflation of endotracheal tube cuffs in all anesthesia team. Palpation in order to assess the adequacy of cuff inflation is not sufficient and anesthesia providers should consider using devices such as manometers to facilitate safe inflation and accurate measurement of endotracheal tube cuff pressure.