We thank our international colleagues for their meaningful review and comments related to our study. Similar to our previous study, we found that endotracheal tube (ETT) cuff pressure was not a static measure. We reviewed the digital tracings from the study and made several clinical observations related to cuff pressure variability.

During the synchronous intermittent mandatory ventilation mode, the peak cuff pressure was higher during the mandatory breaths, likely related to changes in airway pressure. We observed changes in pressure during and after turning, attributed to position of the head and neck and its influence on the ETT cuff itself.

We observed transient pressure increases during coughing and suctioning the endotracheal tube; the pressure quickly returned to baseline. We also observed that in patients who were agitated, greater variability in ETT cuff pressure occurred, and that variability decreased after the patient received sedation...

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