Endotracheal Cuff Pressures in Ventilated Patients in Intensive Care

There are well over 50,000 patients who receive ventilation via an endotracheal tube in the Intensive Care Units (ICUs) in Australia and New Zealand every year. Almost all episodes of invasive ventilation in adults are associated with inflation of endotracheal cuff. While monitoring of the cuff pressure has been recommended during anaesthesia this has not been reflected in any of the minimum standards documents. Endotracheal tubes placed in the Operating Theatre (OT) are usually in situ for a matter of hours, while endotracheal intubation in ICU is more prolonged, and thus the risk of time dependent sequelae is increased.
If the Pcuff is excessively elevated the cuff has the potential to herniate or to cause direct damage through ischemia of the tracheal mucosa.