Disposable Airway Pressure Manometers for Endotracheal Tube Cuff Inflation

SIMPLE SUMMARY: Evidence suggests that the cuff pressure of endotracheal tubes with high-volume, low-pressure cuffs should be maintained between 20 and 30 cmH(2)O. Blind techniques for cuff inflation have been shown to rarely result in an optimal cuff pressure, even when used by experienced anaesthesiologists. The authors therefore emphasise the necessity for direct measurement of the cuff pressure using a manometer. Despite a wide array of commercially available cuff pressure manometers, many veterinary facilities still use blind techniques or repurposed aneroid blood pressure manometers, which have been proven unreliable for this application. With cost being a major concern, especially for smaller veterinary facilities, the aim of this study was to find a cost-effective alternative to commercially available cuff manometers and test them for their usability, accuracy, precision and repeatability. This study assessed the performance of two disposable airway manometers for endotracheal tube cuff inflation in a benchtop model. Both of the tested devices present cost-effective and accurate alternatives to commercial cuff manometers. ABSTRACT: This study aimed to assess the performance, accuracy, precision and repeatability of two single-use airway pressure manometers as a cost-effective alternative for inflation of endotracheal tubes with high-volume, low-pressure cuffs. The manometers were tested in a bench top model against a U-tube manometer. Eighteen units of each device were tested. Three consecutive measurements were performed at pressures of 20, 25 and 30 cmH(2)O each. The mean ± SD of the recorded pressures and maximum deviation from the target pressures were calculated for each device and each target pressure. For device A, the mean ± SD pressures were 19.6 ± 0.7, 23.6 ± 0.8 and 28.3 ± 0.8 cmH(2)O; for device B, the mean ± SD pressures were 19.3 ± 0.6, 24.3 ± 0.9 and 29.2 ± 0.67 cmH(2)O for target pressures of 20, 25 and 30 cmH(2)O, respectively. The bias for device A was −0.4, −1.4, and −1.7 cmH(2)O and for device B, −0.7, −0.7, and −0.8 cmH(2)O for target pressures of 20, 25, and 30 cmH(2)O, respectively. Both devices showed results comparable to those reported for commercial cuff manometers. They represent inexpensive tools that provide clinically sufficient accuracy, precision and repeatability for ETT cuff inflation between pressures of 20 and 30 cmH(2)O.