Can the Intracuff Pressure Be Estimated by Palpation of the Pilot Balloon

Abstract

Background. Over the past 5 years, there has been a change in the clinical practice of pediatric anesthesiology with a transition to the use of cuffed instead of uncuffed endotracheal tubes in infants and children. However, there has been limited attention to techniques to ensure a safe intracuff pressure. We sought to determine the accuracy of estimating endotracheal tube intracuff pressure by palpation of the pilot balloon by anesthesiologists, anesthesia residents, pediatric anesthesia fellows, certified nurse anesthetists, and student nurse anesthetists. Methods. A tracheal simulation model was constructed with 3 different diameters of polyvinylchloride tubing. Three different-sized endotracheal tubes (4.0, 5.0, and 6.0 mm) were then placed into the tubes and the cuffs inflated to various pressures. Each participant was given 3 different scenarios of cuff pressure for each endotracheal tube size for a total of 9 scenarios per practitioner. By feeling the pilot balloon, the anesthesia provider was aske...