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Intensive Care Medicine
Published in: Intensive Care Medicine 6/2010

01-06-2010 | Original

Tracheal pressure and endotracheal tube obstruction can be detected by continuous cuff pressure monitoring: in vitro pilot study

Authors: Shai Efrati, Israel Deutsch, Gabriel M. Gurman, Matitiau Noff, Giorgio Conti

Published in: Intensive Care Medicine | Issue 6/2010

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Abstract

Purpose

To evaluate whether the degree of endotracheal tube (ETT) obstruction can be predicted by changes of ETT cuff pressure (P c) as a function of peak inspiratory pressure.

Methods

The study was conducted in three phases: phase I evaluated the correlation between peak tracheal pressure (P tr) and P c; phase II evaluated the relation between P c versus ventilator pressure (P v) and ETT obstruction (range of obstruction 0–58%). In phase III the analytical model developed in phase II was used to predict the degree of obstruction of five ETTs removed from intensive care unit (ICU) patients. All measurements were conducted on a tracheal–lung simulator.

Results

In phases I and II it was found that P c correlates significantly with P tr. The gradient (dP c/dP v) reflects the degree of ETT obstruction according to the formula: obstruction (%) = −553 × (dP c/dP v)2 + 672.5 × (dP c/dP v) − 142.81. Using this formula, the degree of obstruction of the ETTs could be predicted in ICU patients during controlled mechanical ventilation (r 2 = 0.98, p < 0.001).

Conclusions

This study proposes a new method to predict the degree of ETT obstruction based on differences between P c and P v. The method was proved accurate on simulator, and further studies are needed on intubated patients.
Appendix
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Metadata
Title
Tracheal pressure and endotracheal tube obstruction can be detected by continuous cuff pressure monitoring: in vitro pilot study
Authors
Shai Efrati
Israel Deutsch
Gabriel M. Gurman
Matitiau Noff
Giorgio Conti
Publication date
01-06-2010
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 6/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-010-1835-3

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