How do you manage and monitor endotracheal tube cuff pressures in your unit? Do you have a written protocol? Is it a nursing or solely a respiratory therapy responsibility? Unfortunately, there are few if any “gold standards” in this area.

In this issue, Rose and Redl describe their findings related to the current practices in Australia and New Zealand. Some issues to consider:

  • Underinflation of the endotracheal cuff can lead to aspiration, especially during inspiration, and overinflation can result in tracheal ischemic damage.

  • Four methods for monitoring cuff inflation are used around the world, but there are no data to support one over the other. However, the palpation of the pilot balloon method is used infrequently because it is very subjective and can result in excessive cuff pressures.

  • Cuff pressure may be affected by body position, head alignment, tube...

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