Critically ill patients often require intubation with an endotracheal tube (ETT) to provide an
artificial airway for mechanical ventilation. Management of the artificial airway is an
important part of care rendered by nurses and respiratory therapists. One aspect of airway
management is maintenance of an adequate pressure in the ETT cuff. The cuff is inflated to
seal the airway to deliver mechanical ventilation. A cuff pressure between 20 and 30 cm
H2O is recommended to provide an adequate seal and reduce the risk of complications.1–4
Survey results5–7 indicate that cuff pressure is usually monitored and adjusted every 8 to 12
hours.
ETT cuff pressure varies and may be out of range during the interval between intermittent
measurements, increasing the risk for complications. In this study, we tested the
effectiveness of an intervention, management of the ETT cuff pressure via continuous
monitoring and alarm or clinical triggers, versus intermittent pressure measurement. The
objective was to maintain the ETT cuff pressure within a range of 20 to 30 cm H2O. The
study also provided an opportunity to describe the natural history of ETT cuff pressure over
time.