[Continuous dynamic record of intracuff pressure in endotracheal intubated patients]

As static intracuff pressure record does not represent the pressure changes occurring during sputum suction, cough, and struggle, we have designed a PC polygraph to attempt a continuous dynamic monitoring. By means of a 93-7800 PC polygraph, we obtained 11 continuous dynamic records (129.2 +/- 44.2 min., average) of intracuff pressures from 11 inhalation anesthetized patients and 8 records (23.4 +/- 12.4 min., average) from 6 awake ventilatory assisted patients on whom the Hilo endotracheal tube was used. In anesthetized patients, the ratios of peak pressure (P) to base line pressure (P) labeled in 8 oral suction, 23 endotracheal suction, and 11 struggles were 181.2 +/- 63.1%, 161.8 +/- 51.9% and 162.0 +/- 53.9% respectively. The ratios of labeled complex average pressure (P) to base line pressure were 132.8 +/- 32.5%, 126.2 +/- 27.3% and 126.1 +/- 27.8% respectively. In awake ventilatory assisted patients, the ratios of P/P labeled in 15 oral suction, 45 endotracheal suction, 28 coughs, and 8 struggles were 235.0 +/- 69.4%, 305.0 +/- 295.7%, 236.9 +/- 80.0%, and 174.7 +/- 65.0% respectively. The ratios of P/P were 131.9 +/- 55.9%, 139.5 +/- 50.1%, 156.9 +/- 46.8%, and 122.1 +/- 36.5%. Reduction of endotracheal cuff pressure was noted immediately after removal of upper intrathoracic tumors measuring from 56.8 +/- 7.6 mmHg to 41.9 +/- 6.4 mmHg in 3 patients. Time summation of the labeled events in five of our six ICU patients averaged less than 6% during the entire course of monitoring.(ABSTRACT TRUNCATED AT 250 WORDS)