Tracheal tube cuff pressure depends on the anaesthesiologist's experience. A follow-up study.

Abstract

Background: Excessive tracheal tube cuff pressure can cause ischemia of the tracheal mucosa, and possible serious complications, such as tracheal stenosis, formation of tracheo-oesophageal fistula or even life-threatening haemorrhage. Inadequate cuff pressure increases the risk of aspiration of gastric contents.

Methods: The cuff pressures were analysed on the basis of the anaesthesiologists' experience. The results were compared to those obtained during the previous study which had been conducted seven years earlier (2002). The physicians were divided into three groups, according to their experience: group I - less than 2 years of practice; group II--2 to 10 years of practice; and group III--over 10 years of practice. High-volume, low-pressure tubes were used for intubation. The anaesthesiologists were not informed of the planned audit.

Results: Statistical analysis demonstrated significant differences between cuff pressure readings in the respective study groups. Cuff pressures in group II (p < 0.05) and group III (p < 0.0005) were greater than those in group I. In 2002, no statistically significant differences had been observed between the three groups (p = 0.1156). When comparing results from 2002 and present one differences were observed inside individual groups, concerning group II (p < 0.05) and group III (p < 0.0005).

Conclusion: There is a tendency to overinflation of endotracheal tube cuffs in all groups. This problem is more common in the group of highly experienced anaesthesiologists, and is more more prevalent at present than in 2002.