RESUMO
BACKGROUND: Endotracheal tube cuff pressure must be kept in an optimal range, but it might change during some nursing procedures. If the cuff pressure gets outside the normal range, it can cause mucosal damage, insufficient ventilation, and microaspiration. This study aimed to determine the effect of endotracheal suctioning on cuff pressure in patients during mechanical ventilation. MATERIALS AND METHODS: This is a quasi-experimental study utilizing repeated measures with a within-subject design. Using a simple convenience sampling method, 61 patients were studied during intubation on mechanical ventilation. Baseline cuff pressure was adjusted to 25 cm H 2 O. Then, at 15, 30, and 60 minutes' intervals, cuff pressures were measured once without suctioning and again after suctioning. RESULTS: The results showed a significant change in the mean endotracheal tube cuff pressure during suctioning (p<0.001, d=7.47). During suctioning, cuff pressure exceeded the normal range in 64% of the patients. After suctioning, although endotracheal tube cuff pressure decreased in both conditions, it decreased more significantly (F (2.17, 260.55)=238.19, p<0.001, ν=0.665, d=1.37) in the suctioning condition. CONCLUSION: The results suggest that endotracheal tube cuff pressure increases suddenly and briefly during suctioning, but within 60 minutes after suctioning, it becomes more reduced in suctioning conditions than without suctioning. Therefore, patients are at risk of mucosal damage and microaspiration after and during suctioning, respectively. It is suggested that nurses use continuous cuff pressure regulation methods to prevent potential risks.
RESUMO
BACKGROUND: Usually, the endotracheal tube cuff pressure is controlled by cuff pressure monitoring. However, the intermittent pilot-manometer connection and disconnection may cause a change in the adjusted pressure. This study aimed to investigate changes in the endotracheal tube cuff pressure using both manual and intermittent controls. MATERIALS AND METHODS: A semi-experimental within-subject design was conducted. Fifty-nine intubated patients in the Mazandaran Intensive Care Units (ICUs) participated through convenience sampling in 2018. In the control condition, first, the cuff pressure was adjusted in 25 cm H2O then it was measured without manometer-pilot disconnection at 1 and 5 min intervals. In the intervention condition, cuff pressure was immediately adjusted in 25 cm H2O then it was measured with manometer-pilot disconnection in the 1st and 5th minutes. Data analysis was performed using Independent t-test, Chi-square test, and Phi coefficient. RESULTS: The mean and Standard Deviation (SD) change of cuff pressure after 1 minute, from 25 cm H2O, in the intervention condition was 20.22 (3.53) cm H2O. The mean (SD) of this change in the control condition was 25.22 (3.39) cm H2O. This difference was significant (t 116 = 7.83, p < 0.001, d = 1.44). The mean (SD) change of cuff pressure after 5 minutes, from 25 cm H2O, in the intervention condition was 19.11 (2.98) cm H2O. The mean (SD) of this change in the control condition was 25.47 (4.53) cm H2O. This difference was significant (t 116 = 9.24, p < 0.001, d = 1.70). CONCLUSIONS: The tracheal tube cuff pressure has been significantly reduced during manual intermittent measuring. Therefore, it is suggested that continuous cuff pressure monitoring and regulation should be used.
