• critically ill patients
• cuff pressure
• intensive care unit
• ventilator-associated pneumonia

• Pneumonia, Ventilator-Associated/prevention & control
• Humans
• Randomized Controlled Trials as Topic
• Critical Illness/therapy
• Respiration, Artificial/adverse effects
• Respiration, Artificial/instrumentation
• Intensive Care Units
• Male
• Female
• Pressure
• Middle Aged

• Airbag management
• Artificial airway management
• Attitudes
• Health knowledge
• Nurses
• Pathway analysis
• Practice

• Body position change
• Critically ill patient
• Endotracheal tube cuff pressure
• Mechanical ventilation
• Tracheal perfusion

• Endotracheal cuff-pressure monitoring
• ICU
• Standard of care

• Endotracheal intubation
• Post-intubation tracheal stenosis
• Tracheoesophageal fistula
• Tracheomalacia

• Endotracheal tube cuff pressure
• Mechanical ventilation
• Pressure control ventilation
• Volume control ventilation

• Humans
• Respiration, Artificial
• Iran
• Respiration
• Intubation, Intratracheal
• Anesthesia, General

• medical research
• risk factors

• Dental Care
• Hospital Mortality
• Humans
• Inpatients
• Intensive Care Units

• HTA
• hospital decision making
• intensive care unit
• intensive care ventilator
• multi criteria decision analysis
• pediatric

• Cuff
• Defect
• Endotracheal tube
• Inflation tubing
• Leak

• Adult
• Humans
• Insufflation
• Intubation, Intratracheal/adverse effects
• Male
• Respiration, Artificial/adverse effects
• Trachea

• Chlorhexidine
• Mechanically ventilated children
• Oral care
• Ventilator-associated pneumonia

• cuff pressure
• endotracheal tube
• extension of neck
• tapered-shaped cuff

• Adolescent
• Adult
• Aged
• Equipment Design
• Female
• Humans
• Intubation, Intratracheal/instrumentation
• Male
• Middle Aged
• Pressure
• Prospective Studies
• Supine Position
• Thyroidectomy
• Trachea
• Treatment Outcome
• Young Adult

• cuff pressure
• endotracheal tube
• nursing procedures
• pressure loss
• tracheotomy tube

Proper bronchial cuff pressure (BCP) is important when using a double-lumen endotracheal tube (DLT), especially in thoracic surgery. As positional change during endotracheal tube placement could alter cuff pressure, we aim to evaluate the change in BCP of DLT from the supine to the lateral decubitus position during thoracic surgery. A total of 69 patients aged 18–70 years who underwent elective lung surgery were recruited. BCP was measured at a series of time points in the supine and lateral decubitus positions after confirming the DLT placement. The primary outcome was change in the initial established BCP (BCPi), which is the maximum pressure at which the BCP did not exceed 40 cmH₂O without air leak in the supine position, after lateral decubitus positioning. As the primary outcome, the BCPi increased from 25.4 ± 9.0 cmH₂O in the supine position to 29.1 ± 12.2 cmH₂O in the lateral decubitus position (p < 0.001). Out of the 69 participants, 43 and 26 patients underwent surgery in the left-lateral decubitus position (LLD group) and the right-lateral decubitus position (RLD group) respectively. In the LLD group, the BCPi increased significantly (p < 0.001) after lateral positioning and the beginning of surgery and the difference value, ∆BCPi, from supine to lateral position was significantly higher in the LLD group than in the RLD group (p = 0.034). Positional change from supine to lateral decubitus could increase the BCPi of DLT and the increase was significantly greater in LLD that in RLD.

• cuff
• double-lumen tube
• lateral position
• pressure
• thoracic surgery

• cuff pressure management
• cuff pressure monitoring
• educational intervention
• endotracheal tube
• intensive care nurses
• nurses' knowledge

General anaesthesia with tracheal intubation results in sore throat. We evaluated the influence of the two-handed jaw thrust on postoperative sore throat in patients who require tracheal intubation.

In this prospective, double-blind, single-centre, parallel-arm, and randomised trial, 92 patients who were scheduled for general anaesthesia for total hip arthroplasty were allocated to one of two groups. In the jaw thrust group (n = 46), the two-handed jaw thrust manoeuvre was applied at intubation. In the control group (n = 46), conventional intubation with sham jaw thrust was performed. Incidences of airway morbidities including sore throat, hoarseness, and cough at 2, 4, and 24 hours postoperatively were compared.

During the postoperative 24 hours, the incidence of sore throat (8 [17%] vs. 20 [44%]) and hoarseness were lower in the jaw thrust group (8 [17%] vs. 18 [39%]) compared with the control group. The incidence of cough during the postoperative 24 hours was similar between the groups.

The jaw thrust manoeuvre significantly reduced sore throat and hoarseness in patients after general anaesthesia using tracheal intubation.

Clinical trial registration: NCT 03568279.

• Airway management
• anaesthesia
• general
• hoarseness
• intratracheal
• intubation
• pharyngitis
• sore throat

Methods of determining proper endotracheal tube (ETT) cuff pressure to prevent air leakage include the minimal occlusive volume (MOV) technique, which uses auscultation, and the spirometer technique, which directly measures inspiratory and expiratory breathing volumes. Spirometers may measure even small air leakage, therefore, the spirometer technique requires a higher cuff pressure than the MOV technique to completely seal the airway. This study aimed to evaluate the difference in cuff pressure between the two techniques used to seal the airway.

Thirty-five female patients were intubated using an ETT with a cuff, and cuff inflation was performed with both techniques at a 10-min interval in random order—the MOV technique and then the spirometer technique or vice versa. The cuff pressure was measured at each period.

The cuff pressures were 16.7 ± 4.4 cmH₂O and 18.7 ± 5.2 cmH₂O for the MOV and spirometer techniques, respectively. The cuff pressure for the spirometer technique was 2.0 cmH₂O higher than that for the MOV technique and this difference was statistically significant (95% confidence interval, 0.7–3.3; P = 0.003). Considering the upper end (3.3 cmH₂O) of the 95% confidence interval and the size of one scale unit (2.0 cmH₂O) of a manometer, the difference in cuff pressure was up to 4 cmH₂O in practice.

Even though the air leakage sound disappears on auscultation, unlike the previous recommendation, the airway sealing would be completed only by increasing the cuff pressure by approximately 4 cmH₂O.

• Airway management
• Anesthesia
• Endotracheal
• Manometry
• Minimal occlusive volume
• Spirometer

To identify the neonatal, pediatric and mixed (neonatal and pediatric) intensive care units in Brazil that use cuffed tracheal tubes in clinical practice and to describe the characteristics related to the use of protocols and monitoring.

To identify the intensive care units in Brazil, the Ministry of Health’s National Registry of Health Facilities was accessed, and information was collected on 693 registered intensive care units. This was an analytical cross-sectional survey conducted through electronic questionnaires sent to 298 neonatal, pediatric and mixed intensive care units in Brazil.

This study analyzed 146 questionnaires (49.3% from neonatal intensive care units, 35.6% from pediatric intensive care units and 15.1% from mixed pediatric intensive care units). Most of the participating units (78/146) used cuffed tracheal tubes, with a predominance of use in pediatric intensive care units (52/78). Most of the units that used cuffed tracheal tubes applied a cuff pressure monitoring protocol (45/78). The use of cuff monitoring protocols was observed in intensive care units with a physical therapy service exclusive to the unit (38/61) and in those with a physical therapist present 24 hours/day (25/45). The most frequent cause of extubation failure related to the use of cuffed tracheal tubes in pediatric intensive care units was upper airway obstruction.

In this survey, the use of cuffed tracheal tubes and the application of a cuff pressure monitoring protocol was predominant in pediatric intensive care units. The use of a monitoring protocol was more common in intensive care units that had a physical therapist who was exclusive to the unit and was present 24 hours/day.

• Cirurgia de cabeça e pescoço
• Cirurgia de orelha
• Ear surgery
• Endotracheal tube
• Head and neck surgery
• Intracuff pressure
• Posição cirúrgica
• Pressão intracuff
• Surgery-related position
• Tubo endotraqueal

• Hospital-acquired infections
• critical care nursing
• cross-infection
• hand hygiene
• pneumonia
• translational medical research
• ventilator-associated

• anesthetists
• cuff pressure
• training

• Fluidized Positioner
• feasibility study
• intensive care unit
• patient positioning
• pressure injury prevention

Endotracheal intubation is routinely performed in the critical situations. In order to prevent microaspiration and tracheal injury endotracheal cuff pressure is important to remain constant between 20 and 30 cmH₂O. Positive pressure ventilation, duration of intubation, body temperature, and body movements can alter endotracheal cuff pressure. This survey was conducted to evaluate core body temperature and cuff pressure relation with airway pressure simultaneously.

This was a descriptive analytic study conducted from March 2018 to July 2018 on 150 intubated patients in the emergency department. All were ventilated with SIMV mode and had Ramsi sedation level of 2-3. Mean airway pressure was measured simultaneouly with core body temperature measurement from ventilator monitor. All these parameters were measured 10 times each hour and documented.

There was a statistically meaningful relation between airway pressure and cuff pressure in the primary evaluation (P=0.02, r=0.19), while none of the subsequent evaluations showed meaningful relation (P>0.05). No significant relation was found between cuff pressure and core body temperature in any of the measurements (P>0.05).

The pressure of cuff should be checked repeatedly after intubation because of substantial variation over time. Factors other than core body temperature and airway pressure can influence cuff pressure.

• Body temperature change
• Emergency department
• Endotracheal intubation

Background: The Suction Above Cuff Endotracheal Tube (SACETT) has a dorsal port above the cuff designed to enable the continuous or intermittent suctioning of secretions from the subglottic space. Thus, it facilitates the suctioning of excessive secretions above the cuff and around the glottis.

Objectives: In this study, we investigated the effect of the using the SACETT on laryngospasm and postoperative complications in rhinoplasty operations.

Methods: This randomized controlled clinical trial enrolled 132 patients undergoing rhinoplasty. The patients were randomly divided into two groups: Suction above Cuff Endotracheal Tube (n=66; Group SA) and classic endotracheal tube (n=66; Group C). Complications following general anesthesia were statistically analyzed among the two groups.

Results: The incidence of postoperative laryngospasm (p=0.02) and respiratory complications was found to be lower in Group SA than in Group C. In addition, the incidence of agitation (p=0.035), postoperative nausea, and vomiting (PONV) (p=0.041), which required antiemetic drug administration, swallowing difficulty (p=0.012), and sore throat (p=0.027) were found to be lower in Group SA than in Group C.

Conclusion: We suggest that using the SACETT in rhinoplasty reduces the incidence of postoperative respiratory complications as well as the incidence of agitation, sore throat, swallowing difficulty, and PONV.

Clinical Trial Number: NCT03584503

• general anesthesia
• laryngospasm
• postoperative complications
• rhinoplasty
• suction above cuff endotracheal tube

• cuff pressure
• double-lumen endotracheal tube
• monitoring
• one lung ventilation
• thoracic surgery

• Adolescent
• Adult
• Aged
• Female
• Humans
• Intubation, Intratracheal/methods
• Male
• Middle Aged
• Patient Positioning/methods
• Pressure
• Prospective Studies
• Thoracic Surgery/methods
• Young Adult

• Research Institute of Medical Science, Catholic University of Daegu

• cuff
• endotracheal tube
• intubation
• lateral rotation
• pressure

• Adolescent
• Adult
• Aged
• Anesthesia, General/adverse effects
• Female
• Head
• Humans
• Intubation, Intratracheal/adverse effects
• Intubation, Intratracheal/methods
• Male
• Middle Aged
• Patient Positioning/adverse effects
• Patient Positioning/methods
• Pressure
• Prospective Studies
• Young Adult

The purpose of this study was to compare the endotracheal tube cuff pressure changes during laparoscopic surgeries using air versus nitrous-oxide in anesthetic gas mixture; and to observe the incidences of postoperative sore throat, hoarseness and dysphagia.

Total 100 patients scheduled for elective laparoscopic abdominal surgery were allocated into two groups. Group A (n = 50) received air while Group N (n = 50) received nitrous-oxide in anesthetic gas mixture. After endotracheal intubation, cuff was inflated with air to achieve sealing pressure. Cuff pressure at baseline (sealing pressure), 30 min, 60 min and 90 min was recorded with a manometer. Incidence of sore throat, hoarseness and dysphagia was noted at the time of discharge from post-anesthesia care unit and 24 h after extubation.

Cuff pressure increased from baseline in both the groups. The increase in cuff pressure in Group N was greater than that in Group A at all time points studied (p < 0.001). Within Group A, cuff pressure increased more at 90 min than at 30 min (p < 0.05). Within Group N, increase in cuff pressure was more at each time point (30, 60 and 90 min) than its previous time point (p < 0.05). The incidence of sore throat in post-anesthesia care unit was higher in Group N than in Group A.

Use of nitrous-oxide during laparoscopy increases cuff pressure resulting in increased incidence of postoperative sore throat. Cuff pressure should be monitored routinely during laparoscopy with nitrous-oxide anesthesia.

• Anestesia
• Anesthesia
• Endotracheal cuff pressure
• Laparoscopia
• Laparoscopy
• Nitrous oxide
• Pressão do balonete endotraqueal
• Óxido nitroso

• Cuff controller
• Infection control
• Intubation
• Subglottic drainage
• Ventilator-associated pneumonia

• Intubation
• Microaspiration
• Tracheal cuff
• Ventilator-associated events
• Ventilator-associated pneumonia

• Aged
• Amylases/analysis
• Biomarkers/analysis
• Cross-Over Studies
• Enzyme-Linked Immunosorbent Assay
• Equipment Design
• Female
• Humans
• Intensive Care Units
• Intubation, Intratracheal/adverse effects
• Intubation, Intratracheal/instrumentation
• Male
• Middle Aged
• Pepsin A/analysis
• Pneumonia, Ventilator-Associated/diagnosis
• Pneumonia, Ventilator-Associated/etiology
• Pneumonia, Ventilator-Associated/microbiology
• Pneumonia, Ventilator-Associated/prevention & control
• Prospective Studies
• Respiration, Artificial/adverse effects
• Respiratory Aspiration of Gastric Contents/enzymology
• Respiratory Aspiration of Gastric Contents/etiology
• Respiratory Aspiration of Gastric Contents/microbiology
• Respiratory Aspiration of Gastric Contents/prevention & control

• N° 2012_45 French Ministry of Health, Programme Hospitalier de Recherche Clinique Interrégional

• Acetaminophen
• Dexamethasone
• Intubation
• Pharyngitis
• Postoperative pain

• intubation, equipment–cuffs, tracheal, monitoring–intensive care, monitoring–cuff pressure, airway

• Children
• Cuff pressure
• Mouth prop

• Critical care
• Cuff pressure
• Endotracheal tube
• Nursing
• Position change

• Adult
• Aged
• Aged, 80 and over
• Critical Illness
• Female
• Humans
• Intubation, Intratracheal
• Male
• Middle Aged
• Patient Positioning
• Prospective Studies
• Respiration, Artificial
• Turkey