Related Experiment Video
Updated: Jan 8, 2026
A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
Published on: October 17, 2017
Cuff Pressure in Pediatric Patients: From Monitoring to Clinical Practice
Joana Gomes1, Sara Cabete1, Luís Pedro1
1Clinic of Anesthesiology, Intensive Care, Emergency and Urgent Care Medicine, Unidade Local de Saúde de Santo António, Porto, PRT.
Insights
Endotracheal tube cuff pressure (Pcuff) monitoring is crucial but often overlooked in pediatric anesthesia. This audit found inadequate Pcuff in over half of pediatric patients, highlighting the need for routine objective measurements to prevent complications.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
- Medical Device Monitoring
Background:
- Endotracheal tube cuff pressure (Pcuff) is vital for ventilation and preventing airway complications.
- Current anesthetic practice often lacks mandatory Pcuff monitoring.
- Maintaining adequate Pcuff is essential for patient safety during general anesthesia.
Purpose of the Study:
- To evaluate Pcuff in pediatric patients undergoing general anesthesia with endotracheal intubation.
- To assess Pcuff levels post-induction and at the end of surgical procedures.
- To determine the prevalence of inadequate Pcuff in this population.
Main Methods:
- Prospective audit of pediatric patients (<18 years) undergoing endotracheal intubation.
- Objective Pcuff measurement using a calibrated cuff manometer.
- Pcuff adjusted to the reference range (20-30 cmH2O) and recorded at two time points.
Main Results:
- 37.8% of patients had adequate Pcuff post-induction; 28.9% were low, 33.3% were high.
- At procedure end, 51.1% had low Pcuff, 46.7% were adequate, and 2.2% were high.
- Positive correlation found between patient age and Pcuff at the end of surgery.
Conclusions:
- Over 50% of pediatric patients exhibited inadequate Pcuff post-induction and at procedure conclusion.
- Routine, objective Pcuff measurement is recommended to maintain optimal levels.
- Consistent monitoring can potentially reduce anesthesia-related airway complications.
Introduction:
Monitoring of endotracheal tube cuff pressure (Pcuff), although recommended, is not mandatory in daily anesthetic practice. An adequate Pcuff is essential to ensure adequate ventilation, prevent potential microaspirations, and avoid airway complications. The goal of this clinical audit was to evaluate Pcuff after anesthetic induction and at the end of the procedure in pediatric patients undergoing general anesthesia with endotracheal intubation.
Methods:
This prospective audit included all pediatric patients (<18 years) who underwent endotracheal intubation for elective and urgent surgeries during one month. After anesthetic induction, Pcuff values were measured objectively using a portable and calibrated cuff manometer and adjusted to the reference range (20-30 cmH2O) if outside this interval. A new evaluation was performed at the end of the surgical procedure. Pcuff values at those two time points were recorded, along with demographic, surgical, anesthetic, and intubation-related data.
Results:
Fifty patients were included, with five excluded due to the absence of Pcuff measurements at the start or end of the procedure. After anesthetic induction, 37.8% (n=17) of the 45 patients had Pcuff within the reference range, while 28.9% (n=13) had Pcuff below 20 cmH2O, and 33.3% (n=15) exceeded 30 cmH2O. At the end of the procedure, 51.1% (n=23) of patients had Pcuff below 20 cmH2O, 2.2% (n=1) had Pcuff above 30 cmH2O and 46.7% (n=21) were within the 20-30 cmH2O range. There was a positive correlation between age and Pcuff at the end of surgery. Procedure duration and the type of tube did not appear to influence final cuff pressure.
Conclusion:
More than 50% of the patients presented an inadequate Pcuff after anesthetic induction as well as at the end of the procedure. This study highlights that the routine implementation of objective and quantitative Pcuff measurements after induction and during the procedure could help maintain normal Pcuff values during anesthesia, potentially reducing complications related to pressure changes.
More Related Videos
06:51Development of an Algorithm to Perform a Comprehensive Study of Autonomic Dysreflexia in Animals with High Spinal Cord Injury Using a Telemetry Device
Published on: July 29, 2016
08:54Measuring Blood Pressure in Mice using Volume Pressure Recording, a Tail-cuff Method
Published on: May 15, 2009
Related Concept Videos
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:21Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:29Drug Dosing: Infants and Children
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:23Assessment of blood pressure in brachial artery(two-step method)