Tracheal tube cuff inflation guided by pressure volume loop closure associated with lower postoperative cuff-related complications: Prospective, randomized clinical trial

ABSTRACT

The main function of an endotracheal tube [ETT] cuff is to prevent aspiration. High cuff pressure is usually associated with postoperative complications. We tried to compare cuff inflation guided by pressure volume loop closure [PV-L] with those by just to seal technique [JS] and assess the postoperative incidence of sore throat, cough and hoarseness. In a prospective, randomized clinical trial, 100 patients' tracheas were intubated. In the first group [n = 50], ETT cuff inflation was guided by PV-L, while in the second group [n. = 50] the ETT cuff was infl ated using the JS technique. Intracuff pressures and volumes were measured. The incidence of postoperative cuff-related complications was reported. Demographic data and durations of intubation were comparable between the groups. The use of PV-L was associated with a lesser amount of intracuff air [4.05 [3.7-4.5] vs 5 [4.8-5.5], P < 0.001] and lower cuff pressure than those in the JS group [18.25 [18-19] vs 33 [32-35], P incidence of postextubation cuff-related complications was significantly less frequent among the PV-L group patients as compared with the JS group patients [P hoarseness of voice, which was less frequent among the PV-L group, but not statistically significant [P pressure after intubation and before extubation revealed a statistically significant association with the technique used for cuff inflation [P < 0.0001]. The study confirms that PV-L-guided ETT cuff inflation is an effective way to seal the airway and associates with a lower ETT cuff pressure and lower incidence of cuff-related complications