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It has been agreed that the safe endotracheal tube intracuff pressures ranges from 20cmH2O to 30cmH2O with pressures above that range being dangerous to the patient even for a short time. While there are many different methods of inflation, the cuff manometer is considered the standard. However, its applicability in clinical practice is marred with numerous hindrances. Without the cuff manometer, anaesthesia providers employ a varied range of subjective methods to inflate and estimate optimal ETT cuff pressure. The most common method used is the palpation of the pilot balloon. This method has been shown to administer high ETT cuff pressures which are associated with both early and late post extubation airway symptoms.

intensive care medicine experimental

ACHIEVING RECOMMENDED ENDOTRACHEAL TUBE INTRACUFF PRESSURE: A RANDOMIZED CONTROL STUDY COMPARING LOSS OF RESISTANCE SYRINGE TO PILOT BALLOON PALPATION (THE LOR-ICP TRIAL, NCT02294422)