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A technique to measure the intracuff pressure continuously: an in vivo demonstration of its accuracy
Author(s) -
Krishna Senthil G.,
Ramesh Archana S.,
Jatana Kris R.,
Elmaraghy Charles,
Merz Meredith,
Ruda James,
Tobias Joseph D.
Publication year - 2014
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12437
Subject(s) - medicine , cuff , transducer , standard deviation , linear regression , pressure measurement , reproducibility , accuracy and precision , biomedical engineering , anesthesia , statistics , surgery , acoustics , mathematics , mechanical engineering , physics , engineering
Summary Objective A major concern with the use of cuffed endotracheal tubes ( cETT ) in children is hyperinflation of the cuff which may compromise tracheal mucosal perfusion. To measure the intracuff pressure (CP), we devised a method using the transducer of an invasive pressure monitoring device. The objective of the study was to test the accuracy and validity of this device for instantaneous and continuous CP monitoring. Methods The study was conducted in 2 phases. In Phase 1 (200 pediatric patients), after inflation of the cuff, the CP was measured using the standard manometer and the transducer simultaneously. In Phase 2 (20 pediatric patients), the transducer was left connected to the pilot balloon of the ETT to obtain a continuous CP reading and the standard manometer was used to measure the CP at 5‐min intervals. Statistical analysis included a Bland–Altman comparison and linear regression analysis. Results In Phase 1, linear regression analysis demonstrated an R 2 value of 0.9956. The bias was 0.30 cmH 2 O, the precision was 0.75 cmH 2 O, and the 95% level of agreement ( LOA ) ranged from −1.16 to 1.77 cmH 2 O. In Phase 2, the linear regression analysis revealed an R 2 value of 0.9846. The bias was 0.28 cmH 2 O, the precision was 0.7 cmH 2 O, and the 95% LOA ranged from −1.1 to 1.66 cmH 2 O. Conclusion Our study demonstrates that when cETT s are used in the pediatric population, the transducer of the invasive pressure monitoring device can be used reliably to measure the CP at the time of inflation and continuously thereafter.