Endotracheal Tube Cuff Inflation Pressure Varieties and Response to Education Among Anesthetists

NCT ID: NCT05034666

Last Updated: 2021-09-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 28 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-01-01
• Study Completion Date: 2018-05-01

Brief Summary

Cuff pressure is essential in endotracheal tube management. Guidelines recommend a cuff pressure of 20 to 30 cm H2O. One study, for instance, found that cuff pressure exceeded 40 cm H2O in 40-to-90% of tested patients.

This study will investigate the endotracheal ETT cuff inflation pressure applied by the participating anaesthetists, and their response after being informed about the pressure the participants will apply.

Detailed Description

Although the increasing uses of different supraglottic devices as an alternative, the traditional endotracheal intubation is still considered the commonly used method for managing the airway of a generally anaesthetized patient. After passing the endotracheal tube through the larynx, the anaesthetist inflates the cuff or asks the anaesthesia technician to inflate it. How much air is injected into the cuff is not a major concern for almost all anaesthetists and they usually depend on palpating the external cuff tense to judge is it too much, accurate or not enough? Cuff pressure is essential in endotracheal tube management. Guidelines recommend a cuff pressure of 20 to 30 cm H2O. Inflation of the cuff of pressure more than 30 cm H2O can damage the tracheal mucosa by compromising capillary perfusion. When pressures are greater than 50 cm H2O, total obstruction of tracheal blood flow occurs. For long times, without any evidence-based data, it has been believed that well-trained anaesthetists are capable of determining proper ETT cuff pressures. It is presumed that anaesthetists can detect appropriate inflation pressure and overinflated ETT cuff by palpating the ETT pilot balloon. Adequacy of cuff inflation is conventionally determined by palpation of the external balloon. Previous studies suggest that this approach is unreliable. One study, for instance, found that cuff pressure exceeded 40 cm H2O in 40-to-90% of tested patients. However, increased awareness of over-inflation risks may have improved recent clinical practice.

The aim of the work: This study will investigate the endotracheal cuff inflation pressure applied by the participating anaesthetists, and their response after being informed about the pressure the participants will apply. Material and Methods: Type of the study: Prospective controlled single-blind study. Settings: After obtaining approval by the Ethics Committee of the Suez Canal University Hospital, and written informed consent with an explanation regarding the purpose, effects, technique, and complications, all anaesthetists, working currently in the facility, are included.

Conditions

Endotracheal Tube

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: SEQUENTIAL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: SINGLE

Study Groups

Before education

Before alarming the participant anaesthetists about the pressure values of their practice in inflating the ETT cuff.

This is before applying the intervention which is informing and educating the participant anaesthetists about the proper ETT cuff pressure.

Group Type: ACTIVE_COMPARATOR

Before the education program

Intervention Type: BEHAVIORAL

Before applying the education program of the endotracheal cuff pressure inflation to the participating anaesthetists.

After education

After alarming the participant anaesthetists about the pressure values of their practice in inflating the ETT cuff.

This is after applying the intervention which is informing and educating the participant anaesthetists about the proper ETT cuff pressure.

Group Type: ACTIVE_COMPARATOR

After the education program

Intervention Type: BEHAVIORAL

After applying the education program of the endotracheal cuff pressure inflation to the participating anaesthetists.

Interventions

Before the education program

Before applying the education program of the endotracheal cuff pressure inflation to the participating anaesthetists.

Intervention Type: BEHAVIORAL

After the education program

After applying the education program of the endotracheal cuff pressure inflation to the participating anaesthetists.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• anaesthetists
• works at Suez canal university hospital
• resident, registrar, or senior registrar

Exclusion Criteria

• refusal to participate
• who will not complete the 2 rounds 3 readings each

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Suez Canal University

OTHER

Sponsor Role: lead

Responsible Party

Abdelrhman Alshawadfy

Lecturer of anesthesia and intensive care

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Suez Canal University

Ismailia, , Egypt

Countries

Egypt

Other Identifiers

ETT cuff pressure

Identifier Type: -

Identifier Source: org_study_id