Correlations between controlled endotracheal tube cuff pressure and postprocedural complications: a multicenter...

Area of Science:

• Anesthesiology
• Respiratory Medicine
• Surgical Complications

Background:

• Postoperative respiratory complications, including cough, sore throat, hoarseness, and blood-streaked expectorant, are common after endotracheal intubation.
• These complications can impact patient recovery and comfort.

Purpose of the Study:

• To investigate the short-term impact of measuring and controlling endotracheal tube cuff (ETTc) pressure on postprocedural complications.
• To evaluate the effectiveness of proper ETTc pressure management in reducing airway trauma.

Main Methods:

• A study involving 509 patients undergoing elective surgery under general anesthesia.
• Patients were divided into a control group (no ETTc pressure measurement) and a study group (ETTc pressure measured and adjusted).
• Fiberoptic bronchoscopy was used to assess tracheal mucosa injury in a subset of patients.

Main Results:

• ETTc pressure estimated by palpation was often significantly higher than optimal, reaching up to 210 mm Hg.
• The study group, with adjusted ETTc pressure (mean 20 ± 3.1 mm Hg), showed a significantly lower incidence of sore throat, hoarseness, and blood-streaked expectoration compared to the control group.
• Tracheal mucosa injury was less severe in the study group than in the control group.

Conclusions:

• Palpation-based estimation of ETTc pressure is frequently inaccurate and leads to excessively high pressures.
• Proper control of ETTc pressure using a manometer effectively reduces endotracheal tube-related postprocedural respiratory complications.
• This intervention is beneficial even for short-duration procedures (1-3 hours).