What is the consequences of elevated cuff pressure?

High cuff pressures can result in complications ranging from sore throat and hoarseness to tracheal stenosis, necrosis, and even rupture. In such cases, the postulated causative factor is diminished blood flow to tracheal mucosa due to excessive cuff pressure on the tracheal wall.

Which is a potential complication of a low pressure in the endotracheal tube cuff?

Which of the following is a potential complication of a low pressure in the ET cuff? Low pressure in the cuff can increase the risk for aspiration pneumonia. High cuff pressure can cause tracheal bleeding, ischemia, and pressure necrosis.

What pressure should an ETT cuff be?

between 20 and 30 cmH2O
Based on the majority of human literature, ETT cuff pressure between 20 and 30 cmH2O is considered to be the standard (safe) ETT cuff pressure range (13–15). In veterinary medicine, ETT cuff inflation is usually performed with a subjective estimation of the cuff pressure.

What are the complications of over inflating the cuff of a tracheostomy tube?

Complications of cuff over-inflation include: Tracheal stenosis, tracheomalacia, tracheo-esophageal fistula, and tracheo-innominate artery fistula. In addition to increased possibility of airway injury, higher cuff pressures also have a deleterious effect on swallowing.

What is the importance of cuff pressure?

One aspect of airway management is maintenance of an adequate pressure in the ETT cuff. The cuff is inflated to seal the airway to deliver mechanical ventilation. A cuff pressure between 20 and 30 cm H2O is recommended to provide an adequate seal and reduce the risk of complications.

What problem might arise by over inflating an endotracheal tube?

Overinflation of the cuff can result in tissue ischemia, ulceration, and necrosis of the tracheal wall (image 1) while underinflation results in the leak of air and oropharyngeal secretions around the ETT cuff which predisposes the patient to inadequate ventilation, de-recruitment, and aspiration pneumonia.

What is the meaning of cuff pressure?

The gas pressure used to inflate and hold in place the balloon surrounding a tracheal tube or laryngeal airway.

Why is it important to measure cuff pressures?

Complications, some serious, can occur from improper pressure when sealing an airway cuff in the trachea. Over-inflation of the cuff can result in tracheal stenosis, tracheal necrosis, tracheomalacia, and fistula formation to the esophagus or innominate artery.

Why do you inflate the cuff for ET tube?

When inflated, the cuff presses against the tracheal wall to prevent air leakage and pressure loss from the lungs. A cuff prevents the escape of air between the tube and the walls of the trachea and reduces aspiration when a patient is receiving mechanical ventilation.

What is the purpose of the cuff on an endotracheal tube?

The cuff of the endotracheal tube (ETT) is designed to provide a seal within the airway, allowing airflow through the ETT but preventing passage of air or fluids around the ETT. Deliberate or inadvertent movement of the ETT may affect cuff pressure or shift folds in the cuff, mobilizing pooled secretions.

How does a cuff prevent aspiration?

The definition of aspiration is when any food, liquid, or other matter passes below the vocal folds. Therefore, the cuff cannot prevent aspiration as it is located below the vocal folds (see Figure 1).

What is cuff deflation?

When the cuff is deflated, some airflow is reestablished through the upper airway. There is movement of airflow both through the tracheostomy tube as well as through the upper airway. This increases the effective airway diameter.

What is the purpose of inflating a cuffed endotracheal tube?

Endotracheal Tube Cuff Pressure. To prevent potential microaspirations around the ETT cuff, maintenance of adequate cuff pressure is essential. Although sealing the airway around the ETT cuff by high inflation pressure would be effective, high pressures threaten perfusion and integrity of the tracheal mucosa.

When should you deflate a cuff?

The definition of aspiration is when any food, liquid, or other matter passes below the vocal folds. Therefore, the cuff cannot prevent aspiration as it is located below the vocal folds (see Figure 1). When neither mechanical ventilation or a risk of gross aspiration is present, the cuff should be deflated.

Does an inflated cuff prevent aspiration?

The following are indications for cuff inflation: Inflate cuff 24 hours following initial tracheostomy tube placement (prevents accumulation of subcutaneous air and aspiration of secretions)