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We should care more about intracuff pressure: The actual situation in government sector teaching hospital

Endotracheal tube (ETT) should have intracuff pressure (ICP) in the range of 20 to 30 cm water (H(2)O). In this observational study, we studied the trend amongst anaesthesiologist in choosing the type of ETT and their ability to assess optimum ICP clinically. After institutional ethics committee app...

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Autores principales: Trivedi, Lopa, Jha, Pramila, Bajiya, Narasi Ram, Tripathi, DC
Formato: Texto
Lenguaje:English
Publicado: Medknow Publications 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943700/
https://www.ncbi.nlm.nih.gov/pubmed/20882173
http://dx.doi.org/10.4103/0019-5049.68374
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author Trivedi, Lopa
Jha, Pramila
Bajiya, Narasi Ram
Tripathi, DC
author_facet Trivedi, Lopa
Jha, Pramila
Bajiya, Narasi Ram
Tripathi, DC
author_sort Trivedi, Lopa
collection PubMed
description Endotracheal tube (ETT) should have intracuff pressure (ICP) in the range of 20 to 30 cm water (H(2)O). In this observational study, we studied the trend amongst anaesthesiologist in choosing the type of ETT and their ability to assess optimum ICP clinically. After institutional ethics committee approval, we observed 75 patients under general endotracheal anaesthesia in Government Medical College. Anaesthesiologists were blinded to study purpose. The type of ETT used and magnitude of ICP was recorded. ICP was measured using simple aneroid manometer. Once the pressure was measured, it was readjusted to normal range and nitrous oxide was allowed to start. Red rubber tube was used in 18.7% and polyvinyl chloride (PVC) in 81.3% cases. The anaesthesiologists were not able to assess ICP in the recommended range clinically in 100% cases when red rubber ETT was used and in 40% cases when portex ETT was used. Red rubber ETT (reusable) with low-volume high-pressure cuff is still in use, though the trend is shifting towards more of using PVC ETT. Anaesthesiologists were not able to inflate the ETT cuff to the recommended range in spite of their clinical expertise (more than 5 years of teaching experience) in significant number of cases. We recommend the use of simple aneroid manometer for objective monitoring of ICP over subjective assessment, not only in red rubber, but also in PVC ETT.
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spelling pubmed-29437002010-09-29 We should care more about intracuff pressure: The actual situation in government sector teaching hospital Trivedi, Lopa Jha, Pramila Bajiya, Narasi Ram Tripathi, DC Indian J Anaesth Clinical Investigation Endotracheal tube (ETT) should have intracuff pressure (ICP) in the range of 20 to 30 cm water (H(2)O). In this observational study, we studied the trend amongst anaesthesiologist in choosing the type of ETT and their ability to assess optimum ICP clinically. After institutional ethics committee approval, we observed 75 patients under general endotracheal anaesthesia in Government Medical College. Anaesthesiologists were blinded to study purpose. The type of ETT used and magnitude of ICP was recorded. ICP was measured using simple aneroid manometer. Once the pressure was measured, it was readjusted to normal range and nitrous oxide was allowed to start. Red rubber tube was used in 18.7% and polyvinyl chloride (PVC) in 81.3% cases. The anaesthesiologists were not able to assess ICP in the recommended range clinically in 100% cases when red rubber ETT was used and in 40% cases when portex ETT was used. Red rubber ETT (reusable) with low-volume high-pressure cuff is still in use, though the trend is shifting towards more of using PVC ETT. Anaesthesiologists were not able to inflate the ETT cuff to the recommended range in spite of their clinical expertise (more than 5 years of teaching experience) in significant number of cases. We recommend the use of simple aneroid manometer for objective monitoring of ICP over subjective assessment, not only in red rubber, but also in PVC ETT. Medknow Publications 2010 /pmc/articles/PMC2943700/ /pubmed/20882173 http://dx.doi.org/10.4103/0019-5049.68374 Text en © Indian Journal of Anaesthesia http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigation
Trivedi, Lopa
Jha, Pramila
Bajiya, Narasi Ram
Tripathi, DC
We should care more about intracuff pressure: The actual situation in government sector teaching hospital
title We should care more about intracuff pressure: The actual situation in government sector teaching hospital
title_full We should care more about intracuff pressure: The actual situation in government sector teaching hospital
title_fullStr We should care more about intracuff pressure: The actual situation in government sector teaching hospital
title_full_unstemmed We should care more about intracuff pressure: The actual situation in government sector teaching hospital
title_short We should care more about intracuff pressure: The actual situation in government sector teaching hospital
title_sort we should care more about intracuff pressure: the actual situation in government sector teaching hospital
topic Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943700/
https://www.ncbi.nlm.nih.gov/pubmed/20882173
http://dx.doi.org/10.4103/0019-5049.68374
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