| ORIGINAL ARTICLE |
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| Year : 2013 | Volume
: 3
| Issue : 4 | Page : 262-268 |
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Evaluation of tracheal cuff pressure variation in spontaneously breathing patients
Gustavo A Plotnikow1, Nicolas Roux2, Viviana Feld2, Emiliano Gogniat2, Dario Villalba2, Noelia Vairo Ribero2, Marisa Sartore2, Mauro Bosso2, Corina Quiroga1, Valeria Leiva1, Mariana Scrigna2, Facundo Puchulu2, Eduardo Distéfano2, Jose Luis Scapellato3, Dante Intile1, Fernando Planells2, Diego Noval2, Pablo Buñirigo2, Ricardo Jofré2, Ernesto Díaz Nielsen2
1 Respiratory Care Services, Clínica Basilea; Intensive Care Unit, Sanatorio Anchorena, Buenos Aires, Argentina
2 Respiratory Care Services, Clínica Basilea, Argentina
3 Intensive Care Unit, Sanatorio Anchorena, Buenos Aires, Argentina
Correspondence Address:
Gustavo A Plotnikow
Gral, Pueyrredón 261, 1888, Florencio Varela, Buenos Aires
Argentina
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2229-5151.124148
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Background: Most of the studies referring cuff tubes' issues were conducted on intubated patients. Not much is known about the cuff pressure performance in chronically tracheostomized patients disconnected from mechanical ventilation.
Objective : To evaluate cuff pressure (CP) variation in tracheostomized, spontaneously breathing patients in a weaning rehabilitation center.
Materials and Methods: Experimental setup to test instruments in vitro, in which the gauge (TRACOE) performance at different pressure levels was evaluated in six tracheostomy tubes, and a clinical setupin which CP variation over 24 h, every 4 h, and for 6 days was measured in 35 chronically tracheostomized clinically stable, patients who had been disconnected from mechanical ventilation for at least 72 h. The following data were recorded: Tube brand, type, and size; date of the tube placed; the patient's body position; the position of the head; axillary temperature; pulse and respiration rates; blood pressure; and pulse oximetry.
Results : In vitro difference between the initial pressure (IP) and measured pressure (MP) was statistically significant (P < 0.05). The difference between the IP and MP was significant when selecting for various tube brands (P < 0.05). In the clinical set-up, 207 measurements were performed and the CP was >30 cmH 2 O in 6.28% of the recordings, 20-30 cmH 2 O in 42.0% of the recordings, and <20 cmH 2 O in 51.69% of the recordings.
Conclusion : The systematic CP measurement in chronically tracheostomized, spontaneously breathing patients showed high variability, which was independent of tube brand, size, type, or time of placement. Consequently, measurements should be made more frequently. |
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