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[Cuff pressure in endotracheal intubation: should it be routinely measured?]
J A Curiel García1, F Guerrero-Romero, M Rodríguez-Morán
1Hospital General Regional, Instituto Mexicano del Seguro Social (IMSS), Delegación Durango.
Objective:
To determine the relationship between endotracheal tube cuff pressure and post-surgical tracheal pain.
Material And Methods:
Cross-sectional study of forty subjects who required endotracheal intubation for elective surgery allocated into two groups according to tube cuff pressure. Subjects who had cuff pressure equal to or less than 42 Mmhg were assigned to Group A, and those with cuff pressure higher than 42 Mmhg to group B. Cuff pressure measurements were carried out previously to removing the endotracheal tube. Low-pressure, high-volume type of tube was used in all subjects. Tracheal pain was evaluated at 60 min and 24 h after extubation.
Results:
There were not differences in the intubation time required (117 +/- 36.9 min vs. 133 +/- 64.9 min, p = 0.3) or in the number of tracheal tubes used in both groups. Tracheal pain was similar in both groups 60 min after extubation, but at 24 h persisted only in 10% of subjects in group A and 53.3% of B, p = 0.02. The correlation between tracheal pain and tube cuff pressure at 24 h was 0.76, p = 0.00001.
Conclusions:
High tube cuff pressure is a related factor to the tracheal pain so must be considered a routine monitoring of cuff pressure and device to avoid cuff pressure that exceeds the necessary minimum.