We value and appreciate Dr Nseir’s comments and questions regarding our clinical study, as he is the international leader in the area of endotracheal tube (ETT) cuff pressure management to prevent microaspiration. In previous studies, we found that ETT cuff pressure decreased over time, often to extremely low levels for extended intervals when the ETT cuff pressure was not measured.1–4  In this study, we wanted to determine if assessing cuff pressure values in a dynamic fashion would assist in maintaining the pressure within a recommended range.

Since we had demonstrated the ability to monitor the ETT cuff pressure with the bedside monitor,3,4  we used this mechanism as a means to test this strategy of managing ETT cuff pressure. By doing so, we recognized many events that occur during dynamic ETT cuff management, including frequent alarms and variation...

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