Relationship between Body Position and Endotracheal Tube Cuff Pressures among Critically Ill Patients | ||||
| Alexandria Scientific Nursing Journal | ||||
| Volume 24, Issue 3, September 2022, Page 64-74 PDF (304.56 K) | ||||
| Document Type: Research articles | ||||
| DOI: 10.21608/asalexu.2022.267756 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Farida Khalil Ibrahim* 1; Asmaa Ebied El- ganauny2; Nagwa Ahmad Reda1; Sahar Younes Othman2 | ||||
| 1Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University | ||||
| 2Critical Care and Emergency Nursing, Faculty of Nursing, Damnhour University | ||||
| Abstract | ||||
| Background: Management of the endotracheal tube cuff pressure is an important part of the care given by critical care nurses for critically ill patients. Over-inflation of the endotracheal tube cuff can cause serious injury and affects blood flow to tracheal mucosa. Under-inflation may cause air leakage which decreases the effect of mechanical ventilation and increases the risk of pulmonary aspiration and accidental extubation. Changes in the patient’s position can cause variation in endotracheal tube cuff pressure. Objective: to identify the relationship between body position and endotracheal tube cuff pressures among critically ill patients. Settings: The study was carried out in Damanhur Medical National Institute General ICU, and Damanhur Chest Hospital ICU, Egypt. Subjects: A convenient sample of 75 adults; orally intubated critically ill patients who are newly admitted to the previously mentioned ICUs Methods: Patients' endotracheal tube cuff pressure was measured at semi-fowler position 45 which was considered the starting position and the cuff pressure was adjusted using the minimum occlusive volume technique and the reading was recorded using a cuff manometer to be the baseline measurement. Then the body position was changed every two hours and the cuff pressure was measured in three different positioned-fowler 30, left lateral, and right lateral positions) immediately, 15 minutes, 30 minutes, 1 hour, and 2 hours after each patient’s body position change. The observed cuff pressures were compared with the basic cuff pressure at the starting position. Results: Significant difference was found (P= 0.000) between ETT cuff pressure mean scores measured immediately and 15 minutes after different body position changes in relation to the baseline measurement. However, a significant difference was found (P= 0.000) only between ETT cuff pressure mean scores measured 30 minutes, 1 hour, and 2 hours after body position change to semi-fowler and right lateral positions in relation to the baseline measurement. Conclusion: The cuff pressure measurements were significantly changed with changing the patients' body positions at different timing. Recommendations: Cuff pressure monitoring using a cuff pressure manometer is mandatory before and after critically ill patients' body position changes. A protocol for the ETT cuff pressure measurement should be developed. | ||||
| Keywords | ||||
| Endotracheal tube; cuff pressure; body position | ||||
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