Monitoring endotracheal tube (ETT) cuff pressures to prevent tracheal injury and microaspiration is important in the care of patients using mechanical ventilation. However, there is limited evidence on the impact of routine position changes on ETT cuff pressure. Lizy and colleagues investigated the effect of 16 body positions on ETT cuff pressure in 12 patients under neuromuscular blockade. They found the following:

  • ETT cuff pressures varied significantly across patients and positions resulting in an inability to predict types of patients and positions that lead to cuff pressures outside the desired range (20–30 cm H2O).

  • Anteflexion and hyperextension of the patient’s head resulted in the greatest increases in cuff pressure.

  • Approximately 41% of position changes resulted in cuff pressures >30 cm H2O, whereas none resulted in cuff pressures <20 cm H2O. Therefore intubated patients are at risk for...

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