• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.156-165
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• 2002

Background: A tracheal stenosis is caused by mucosal ischemic injury related to a high cuff pressure ($P_{cuff}$) of the endotracheal tube. In contrast, aspiration of the upper airway secretion and impaired gas exchange due to cuff leakage is related to a low $P_{cuff}$. To prevent these complications, the $P_{cuff}$ should be kept appropriately because the appropriate $P_{cuff}$ appears to change according to the patient's daily respiratory mechanics. However, the constant cuff volume($V_{cuff}$) has frequently been instilled to the cuff balloon on a daily basis to maintain the optimal $P_{cuff}$ instead of monitoring the $P_{cuff}$ directly at the patients' bedside. To address the necessity of continuous $P_{cuff}$ monitoring, the change in the $P_{cuff}$ was evaluated at various $V_{cuff}$ levels on a daily basis in patients with long-term mechanical ventilation. The utility of mercury column sphygmomanometer for the continuous monitoring $P_{cuff}$ was also investigated. Method: The change in $P_{cuff}$ according to the increase in $V_{cuff}$ was observed in 17 patients with prolonged endotracheal intubation for mechanical ventilation for 2 week or more. This maneuver measured the change in $P_{cuff}$ daily during the mechanical ventilation days. In addition, the $P_{cuff}$ measured by mercury column sphygmomanometer was compared with the $P_{cuff}$ measured by an automatic cuff pressure manager. Results : There were no statistically significant changes of $P_{cuff}$ during more than 14 days of intubation for mechanical ventilation. However the $V_{cuff}$ required to maintain the appropriate $P_{cuff}$ varied from 1.9 cc to 9.6 cc. In addition, the intra-individual variation of the $P_{cuff}$ was observed from 10 $cmH_2O$ to 46 $cmH_2O$ at constant 3 cc $V_{cuff}$. The $P_{cuff}$ measured by the bedside mercury column sphygmomanometer is well coincident with that measured by the automatic cuff pressure manager. Conclusion: Continuous monitoring and management of the $P_{cuff}$ to maintain the appropriate $P_{cuff}$ level in order to prevent cuff related problems during long-term mechanical ventilation is recommended. For this purpose, mercury column sphygmomanometer may replace the specific cuff pressure monitoring equipment.

• Korean Journal of Adult Nursing
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• v.21 no.5
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• pp.538-546
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• 2009

Purpose: The purpose of this study was to identify the effects of cuff pressure on postoperative sore throat. Methods: Data were collected from January 4 through May 15, 2008. Among the 60 patients, 30 patients were randomly assigned to the control group and the rest to the experimental group. Initial cuff pressure of both groups was set at 20 $cmH_2O$. The experimental group was maintained at 20 $cmH_2O$ throughout the anesthesia, while the control group was not regulated further. Sore throat was assessed at postoperative 1, 24 and 72 hours. Data were analyzed using Mann-Whitney test and Spearman's rho coefficients. Results: Cuff pressure in control group increased from 20 to 43 $cmH_2O$ within 3 hours after induction. However, the experimental group showed that there was apparently a reduced rate of sore throat at postoperative 24 hours (p = .048), and 72 hours (p = .002) than in the control group. However, no outstanding differences between both groups at postoperative 1 hour (p = .081) were detected. The correlation between cuff pressure and sore throat was statistically significant ($r_s$ = .590, p < .001). Conclusion: We conclude that maintaining cuff pressure at 20 $cmH_2O$ could be an effective means to reduce sore throat in surgical patients with inhalation anesthesia.

• Journal of Korean Academy of Nursing
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• v.49 no.2
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• pp.215-224
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• 2019

Purpose: To investigate the differences in postoperative sore throat and hoarseness by adjustment of endotracheal tube cuff pressure (CP) during nitrous oxide ($N_2O$) and air anesthesia. Methods: A one-equivalent control group pretest-posttest design was used. Data were collected from August 8 to October 19, 2017 and analyzed using the independent t-test and repeated measures ANOVA. Eighty-four participants were enrolled and divided into three groups: 28 in the Control Group (CP adjusted every 30 minutes using $N_2O$), 28 in Experimental Group 1 (CP adjusted every 10 minutes using $N_2O$), and 28 in Experimental Group 2 (non-adjusted CP using air), all of whom underwent urologic, gynecologic, and orthopedic surgeries at the G University hospital. Sore throat was assessed using a numeric rating scale; hoarseness was evaluate using the Stout classification at 1, 6, and 24 hours after surgery. Results: Scores for sore throat and hoarseness were significantly different between the groups at each measurement time, and scores were consistently higher in the control group. During subsequent measurements, sore throat and hoarseness scores were significantly lower at 6 hours. Cuff pressure changed significantly using air anesthesia (${\chi}^2=10.41$, p=.015) up to 2 hours after induction. Severe sore throat and hoarseness was observed for up to 6 hours after surgery. Conclusion: Cuff pressure adjustment at short time intervals would be helpful in reducing postoperative sore throat and hoarseness. Nursing intervention focused on prevention of sore throat and hoarseness should be required up to 6 hours postoperatively in patients undergoing endotracheal intubation.