Cuff Pressure Monitoring

Perhaps the most frequently overlooked parameter in daily airway care is cuff pressure. Almost commonly, this measurement is ignored in operating room intubations.

Nevertheless, it is well recognized that excessive forces applied to the tracheal mucosa can cause necrosis and ulceration. Cuff pressures of 30 cm H2O for 4 hours have been shown to damage ciliary motility for at least 3 days.

Normal occlusive pressures should be between 20 and 30 cm H2O to avoid complications while maintaining an adequate seal in the tracheal lumen circumferentially around the cuff to prevent microaspiration and ultimately VAP.

It has also been demonstrated that manual palpation of the cuff or instillation of a standard volume of air often underestimates the actual occlusive pressure delivered, leading to unrecognized complications. Therefore, it is recommended that frequent examination of the cuff pressure be documented and trended using cuff pressure gauge.

Reusable aneroid manometers can be onerous to calibrate and are often difficult to locate; in addition, they pose a recurring risk of cross-contamination for each patient. The manometers currently in use in most ICUs provide only a single data point at the time of collection. A commercially available device that constantly measures airway cuff pressures is available. Electronic cuff pressure gauge

Developed by Yaguo Technology is designed to monitor cuff pressure for trachea cannula, tracheotomy tube, or duplex cavity bronchial cannula with high-capacity and low-pressure cuffs. It provides both real-time monitoring and digital display. Alarms will be generated when the lower or upper limit of cuff pressure is exceeded, thus reducing potential risks to patients. No human intervention is required as long as the cuff pressure is in its safety range, which helps reduce workload of clinical medical staff.