Pressure dynamics of endotracheal and tracheostomy cuffs

Abstract

Lateral tracheal wall (LWP), intracuff, and airway pressures were measured in 50 endotracheal and tracheostomy tube cuffs using an acrylic mock trachea. With endotracheal cuffs, LWP ranged from 22 to 180 torr at “minimum leak” and from 26 to 240 torr at “just seal”. With tracheostomy cuffs, LWP ranged from 15 to beyond 200 torr at “minimum leak” and from 23 to beyond 200 torr at “just seal”. High residual volume cuffs usually exerted less LWP than low residual volume cuffs. Few cuffs exerted LWP below capillary perfusion pressure at “minimum leak”; even fewer at “just seal”. A pressure controlled or high compliance pilot balloon system increases safety of cuff systems.