Comparison between Endotracheal Tube Cuff Pressure Measurements Before and After nursing Interventions among Mechanically Ventilated Patients

Abstract

Background: Endotracheal intubation and mechanical ventilation are essential lifesaving procedures for many critically ill patients. Tracheal intubation with a cuffed tube is considered definitive airway management in adults. The tube cuff is designed to provide a seal against aspiration and to prevent leaks during positive pressure ventilation. A cuff pressure between 20 and 30 cmH 2 O has been proposed guideline published by the Royal College of Anaesthetists to prevent the complications of over/under inflation of the cuff. Objective: To compare the endotracheal tube cuff pressure measurements before and after nursing interventions among mechanically ventilated patients. Settings: The study was carried out in the general ICU at Damanhour Medical National Institute that consist of three main halls with fifteen beds; hall I (4 beds), hall II (4 beds), and hall III (8 beds). . Subjects: A convenient sample of 70 adult patients who were mechanically-ventilated via an endotracheal tube with high-volume low-pressure cuff and a diameter ranging from 7 – 8.5 mm were included in the study. Tools: one tool was developed by the researcher used for data collection namely “Endotracheal tube cuff pressure measurement record”. It was used to record the endotracheal tube cuff pressure measurements before and after the selected nursing interventions. It consists of three parts. Cuff pressure was assessed before nursing interventions and after nursing interventions. Results: The majority of the studied sample was male with age 51-60 years. Results of the study showed that there was a significant decrease in the mean values of endotracheal cuff pressure starting before till 30 minutes after the complete bed bath, oral hygiene, and right and left lateral positioning procedures. Conversely in the endotracheal suctioning, the mean value of ETT cuff pressure before showed an increase immediately after, followed by a decrease after 15 minutes, then an increase after 30 minutes. Conclusion: The study concluded that the cuff pressure measurements were significantly changed after performing the selected nursing interventions at different timing. Recommendations: Conducting educational program for the ICU nurses to indicate the importance of the endotracheal tube cuff pressure measurement after performing each of selected nursing interventions.