Evaluation of Tracheal Tube Cuff Pressure Complications in ICU Patients of Shahid Beheshti hospital (2007-2008)

At present despite of wide spread application of tracheal tube with low-pressure cuff, complications of tracheal intubation have not disappeared. The main factor in post intubation tracheal stenosis is high cuff pressure that can cause stimulation and damage of trachea mucosa and thus, it causes scar after extubation. This study was done to define the complications of pressure effects of tracheal tube cuff on trachea.

This study is a cross-sectional study over 60 patients of ICU, who have been intubated for 24 h. In this study cuff pressure was measured every 6h by a cuff pressure monitor and were registered. Then after 2h, 24h, one weak, one month and 3 months after extubation, patients were followed. Presence of cough, stridor and dyspnea were registered. Any doubt of tracheal stenosis was followed by rigid bronchoscopy. Data was recorded and assessed.

The mean age of patients was 45.36±11.3 years that 37 (61.66%) were male and 23 (38.3%) were female. Among patients without pulmonary disease, there were 16 patients (26.66%) with cough and stridor in the first 2 or 24h of extubation but all of them became asymptomatic in following up. Except one patient that because of cough, stridor and dyspnea in the first 24h was undergone rigid bronchoscopy with finding of atelectasis and collaps of lung, no tracheal stenosis or its complications were found.

It seems that maintenance of cuff pressure in the range of 20-30cm H2O and its regular monitoring is the best method for prevention of cuff pressure complications.