Comparison of Tracheal Tube Cuff Pressure with two Technique: Fixed Volume and minimal leak Techniques

Abstract

: endotracheal tube intubation with cuff tube is considered as a Gold standard to maintain the airway; the cuff gets filled with air after placement not only to prevent the air leak but also to prevent aspiration. The appropriate pressure is in a narrow range and estimation techniques are often kaput but still utile in most of units therefore present study was aimed to compare the endotracheal cuff pressure in fixed volume method and minimal leak method.Materials and Methods: this descriptive cross-sectional study was undertaken with a sample size of 110 subjects (55 in each group) whom needed intubation in emergency unit of Imam Reza hospital of Tabriz and did not have exclusion criteria(age under18, not consented to participation).We got a consent form for participation in study from every patient’s care giver. Subjects were randomly assigned to two groups with a digital software. First group undergone intubation by minimal leak group and the second group was intubated by infusion of a fixed volume of 10 cc air into the cuff. Minimal leak method is defined as filling air into cuff until hear air leak at the end of aspiration.The endotracheal tube was from one brand (SUPA) and size 7.5 used for women and 8 for men. The pressures were recorded by a manometer.Data were input in SPSS and statistical tests like independent sample’s t test and Mann- Whitney U test if necessary were used for quantitative studies while chi square used for qualitative studies. The standard range of cuff pressure was considered between 20 and 30 cm H2O and the groups were compared to that range.Results: The average tracheal tube size did not differ significantly in study groups with mean average of 7.51(±0.23) for fixed volume group and 7.60(±0.24) for minimal leak group.(p=0.05)The average intra-cuff pressure in fixed volume group was significantly higher and was about 46.07 (±23.54) and 33.72(±9.14) in minimal leak group.(p=0.028)From this perspective, 56.4 percent of fixed volume group had a normal intra cuff pressure while it was 78.2 percent in minimal leak group which is significantly higher (p=0.025)