Comparison of intermittent and continuous monitoring on endotracheal cuff pressure changes in patients in intensive care units

During patients’ admission to intensive care units (ICUs) and use of an endotracheal tube, the cuff pressure may increase or decrease, both of which are harmful for patients. The best method to measure and maintain the endotracheal tube cuff pressure and also the appropriate times for measurement are not known. This study was conducted to compare the effect of intermittent monitoring with that of continuous monitoring on changes in endotracheal tube cuff pressure in patients admitted to ICUs.

This descriptive comparative study was conducted on 61 intubated patients undergoing mechanical ventilation, aged >18 years, and admitted to ICU. The cuff pressure was first controlled using a manometer, adjusted on 25cm water, monitored continuously for 6 hours using the transducer attached to the monitor, and finally, controlled again using the manometer and modified if necessary. After these procedures, the mean cuff pressure and its changes during the continuous monitoring were compared with those during the two times of intermittent monitoring, and the error rate and limits of agreement were estimated using Bland-Altman test.

The results showed that the mean cuff pressure in the two times of intermittent monitoring was statistically significant (P<0.005). Moreover, the values over the monitoring time fluctuated, but these variations were not statistically significant (P=0.051). The results revealed that the error rate and limits of agreement in both monitoring methods were -1.43±3.99 and -9.41-6.32, respectively.

Considering the error rate and limits of agreement in both methods and their clinical importance, further studies are needed to distinguish the more suitable and preferable method. However, it can be suggested that regular measurement intermittently can keep the cuff pressure in the normal range to a great extent.