Cuff Pressures

Abstract

Background:

To determine areas for clinical improvement associated with cuff pressure. Data collection of cuff pressures were conducted on patients in different hospital units. As there are no set guidelines on the frequency of cuff pressure checking and some literature suggesting potential for slight cuff deflation post cuff pressure check, checking cuff pressures were limited to times when clinically indicated.

Methods:

Cuff pressures were collected over an eight week period by designated senior respiratory therapy students and categorized into five reasons for completing cuff pressure checks. During the collection process a sixth (sub-category) was identified during the collection process. After checking the cuff pressure, it was then set to an acceptable pressure range according to facility guidelines. Facility guidelines noted an acceptable range of 25-30 cm H₂O. SOIRB#: 18-001 Approved by the Southern Oregon IRB Chair on January 24, 2018.

Results:

98 cuff pressures were documented and identified as one of the following categories: Routine Check (RC), inner facility transport (IFT), post intubation (PI), out of facility transfer (OFT), and additional information (AI). The sub-category identified within in IFT was Open Heart surgery patient. Of 98 cuff pressures checked only 10 were within in acceptable limits (25-30cm H₂O) according to hospital guidelines. Of 68 RC only 7 were in acceptable range, and 1 RC pressure was documented to be >30cm H₂O for cuff seal to prevent air leaks. IFT noted 17 cuff pressure checks, 11 of those were open heart patients, and 0 cuff pressures were within acceptable limits for either IFT or open heart patients. PI consisted of 11 cuff pressures checked with 2 being in acceptable range. AI provided 1 cuff pressure check below acceptable range and OFT provided 1 cuff pressure check within acceptable range.

Conclusions:

Collection of cuff pressure data was completed to recognize or identify trends in cuff pressure and if these trends could be correlated to a specific source. It was hypothesized that out of acceptable range cuff pressure data would be identified in OFT, the data collected did not support this hypothesis. Cuff pressure data indicated that most of the time cuff pressure did not meet acceptable range, falling both above and below the 25-30cm H₂O facility guidelines. The brand or type of tube placed was not taken into account.

Disclosures:

None.

Cuff Pressure

	Total	Acceptable Range	Unacceptable Range	Other
RC	68	7	60	1	Documentation to have cuff pressure >30cmH2O
IFT	17	0	17	Open Heart 11	Open Heart Acceptable Range 0
PI	11	2	9
AI	1	0	1
OFT	1	1	0