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Ramírez  Ylián, Tripp  Francisca L, Sandoval Olivares Lizbeth, Santana  Ángel D, Jiménez Ponce Fiacro.
Assessment of cuff presure during general anesthesia in adult patients
Rev Med Hosp Gen Mex 2014; 77(4)  : 167-172

Resumen
 

Background: The insufflation pressure of tracheal tubes is usually determined by the fingerpressure technique has low precision. The minimum leak technique is an alternative to determine whether the cuff is occluding the trachea with safe pressures (20-30 cm of H2O). Our group previously described that 43% of intubated patients had excessive cuff pressures (> 30 cm of H2O) when the finger-pressure technique was used.

Objective: To compare the finger-pressure and minimum leak techniques to achieve safe intracuff pressures in patients undergoing endotracheal intubation. Data was analyzed with t-student and lineal regression.

Methods: Adult surgical patients requiring intubation were randomized in two groups in which cuff insufflation was checked by either the finger-pressure or minimum leak technique. After insufflation, the intracuff pressure was measured using an aneroid manometer. Data analysis was performed to evaluate variables that may affect performance.

Result: Our study included 286 patients (216 female) with a mean age of 44.6 SE ± 14.9 years. The mean insufflation pressures differed significantly between groups (finger-pressure, 36.9 SE ± 1.9 cm H2O; minimum leak, 25.3 SE ± 1.4 cm H2O; P < 0.0001). Each group had 35% of patients with pressures within safe limits. Using finger-pressure, 46% of patient had excessive pressures (>30 cm H2O). Using minimum leak technique, 42% of patients had insufficient pressures (<20 cm H2O). We found a consistent association between the intracuff pressure and the body mass index (r2 = 0.223, P < 0.0001).

Conclusions: Finger-pressure insufflation technique gave mean pressures 11 cm H2O higher than the minimum leak technique but no replace to aneroid manometer.


Palabras clave: Endotracheal intubation; intracuff pressure; general anaesthesia.
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