Cureus · 2025
Cuff Pressure in Pediatric Patients: From Monitoring to Clinical Practice.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Gomes Joana, Cabete Sara, Pedro Luís, Cardoso Tiago Miguel, Duarte Sónia
Аннотация
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.
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.