Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study

Detalhes bibliográficos
Autor(a) principal: Duarte,Nádia Maria da Conceição
Data de Publicação: 2020
Outros Autores: Caetano,Ana Maria Menezes, Arouca,Gustavo de Oliveira, Ferrreira,Andrea Tavares, Figueiredo,José Luiz de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Brasileira de Anestesiologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000100009
Resumo: Abstract Background and objectives: Poor monitoring of tracheal tube cuff pressure may result in patient complications. The objective method of using a manometer is recommended to keep safe cuff pressure values (20‒30 cm H2O). However, as manometers are not readily available, anesthesiologists use subjective methods. We aimed to assess appropriateness of a subjective method for attaining cuff pressure and the expertise level of manometer handling among anesthesiology staff and residents in a university teaching hospital. Methods: Prospective observational study, recruiting participants that performed tracheal intubation and the subjective method for tube cuff inflation. Patients with difficult airway, larynx and trachea anatomic abnormality and emergency procedures were not included. Up to 60 minutes after tracheal intubation, an investigator registered the cuff pressure using an aneroid manometer (AMBU®) connected to the tube pilot balloon. Results: Forty-seven anesthesiologists were included in the study - 24 residents and 23 staff. Mean (SD) and medians (IQR) measured in cmH2O were, respectively, 52.5 (27.1) and 50 (30‒70). We registered 83% of measurements outside the recommended pressure range, with no difference between specialists and residents. The level of expertise with the objective method was also similar in both groups. Pressure adjustments were performed in 76.6% of cases. Conclusion: The subjective method for inflating the tracheal tube cuff resulted in a high rate of inadequate cuff pressures, with no difference in performance between anesthesiology specialists and residents.
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spelling Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational studyTracheal intubationTracheal tubeCuff pressureManometerAnesthesiologistAbstract Background and objectives: Poor monitoring of tracheal tube cuff pressure may result in patient complications. The objective method of using a manometer is recommended to keep safe cuff pressure values (20‒30 cm H2O). However, as manometers are not readily available, anesthesiologists use subjective methods. We aimed to assess appropriateness of a subjective method for attaining cuff pressure and the expertise level of manometer handling among anesthesiology staff and residents in a university teaching hospital. Methods: Prospective observational study, recruiting participants that performed tracheal intubation and the subjective method for tube cuff inflation. Patients with difficult airway, larynx and trachea anatomic abnormality and emergency procedures were not included. Up to 60 minutes after tracheal intubation, an investigator registered the cuff pressure using an aneroid manometer (AMBU®) connected to the tube pilot balloon. Results: Forty-seven anesthesiologists were included in the study - 24 residents and 23 staff. Mean (SD) and medians (IQR) measured in cmH2O were, respectively, 52.5 (27.1) and 50 (30‒70). We registered 83% of measurements outside the recommended pressure range, with no difference between specialists and residents. The level of expertise with the objective method was also similar in both groups. Pressure adjustments were performed in 76.6% of cases. Conclusion: The subjective method for inflating the tracheal tube cuff resulted in a high rate of inadequate cuff pressures, with no difference in performance between anesthesiology specialists and residents.Sociedade Brasileira de Anestesiologia2020-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000100009Revista Brasileira de Anestesiologia v.70 n.1 2020reponame:Revista Brasileira de Anestesiologia (Online)instname:Sociedade Brasileira de Anestesiologia (SBA)instacron:SBA10.1016/j.bjane.2020.02.001info:eu-repo/semantics/openAccessDuarte,Nádia Maria da ConceiçãoCaetano,Ana Maria MenezesArouca,Gustavo de OliveiraFerrreira,Andrea TavaresFigueiredo,José Luiz deeng2020-06-29T00:00:00Zoai:scielo:S0034-70942020000100009Revistahttps://www.sbahq.org/revista/https://old.scielo.br/oai/scielo-oai.php||sba2000@openlink.com.br1806-907X0034-7094opendoar:2020-06-29T00:00Revista Brasileira de Anestesiologia (Online) - Sociedade Brasileira de Anestesiologia (SBA)false
dc.title.none.fl_str_mv Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study
title Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study
spellingShingle Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study
Duarte,Nádia Maria da Conceição
Tracheal intubation
Tracheal tube
Cuff pressure
Manometer
Anesthesiologist
title_short Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study
title_full Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study
title_fullStr Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study
title_full_unstemmed Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study
title_sort Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study
author Duarte,Nádia Maria da Conceição
author_facet Duarte,Nádia Maria da Conceição
Caetano,Ana Maria Menezes
Arouca,Gustavo de Oliveira
Ferrreira,Andrea Tavares
Figueiredo,José Luiz de
author_role author
author2 Caetano,Ana Maria Menezes
Arouca,Gustavo de Oliveira
Ferrreira,Andrea Tavares
Figueiredo,José Luiz de
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Duarte,Nádia Maria da Conceição
Caetano,Ana Maria Menezes
Arouca,Gustavo de Oliveira
Ferrreira,Andrea Tavares
Figueiredo,José Luiz de
dc.subject.por.fl_str_mv Tracheal intubation
Tracheal tube
Cuff pressure
Manometer
Anesthesiologist
topic Tracheal intubation
Tracheal tube
Cuff pressure
Manometer
Anesthesiologist
description Abstract Background and objectives: Poor monitoring of tracheal tube cuff pressure may result in patient complications. The objective method of using a manometer is recommended to keep safe cuff pressure values (20‒30 cm H2O). However, as manometers are not readily available, anesthesiologists use subjective methods. We aimed to assess appropriateness of a subjective method for attaining cuff pressure and the expertise level of manometer handling among anesthesiology staff and residents in a university teaching hospital. Methods: Prospective observational study, recruiting participants that performed tracheal intubation and the subjective method for tube cuff inflation. Patients with difficult airway, larynx and trachea anatomic abnormality and emergency procedures were not included. Up to 60 minutes after tracheal intubation, an investigator registered the cuff pressure using an aneroid manometer (AMBU®) connected to the tube pilot balloon. Results: Forty-seven anesthesiologists were included in the study - 24 residents and 23 staff. Mean (SD) and medians (IQR) measured in cmH2O were, respectively, 52.5 (27.1) and 50 (30‒70). We registered 83% of measurements outside the recommended pressure range, with no difference between specialists and residents. The level of expertise with the objective method was also similar in both groups. Pressure adjustments were performed in 76.6% of cases. Conclusion: The subjective method for inflating the tracheal tube cuff resulted in a high rate of inadequate cuff pressures, with no difference in performance between anesthesiology specialists and residents.
publishDate 2020
dc.date.none.fl_str_mv 2020-02-01
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Anestesiologia
publisher.none.fl_str_mv Sociedade Brasileira de Anestesiologia
dc.source.none.fl_str_mv Revista Brasileira de Anestesiologia v.70 n.1 2020
reponame:Revista Brasileira de Anestesiologia (Online)
instname:Sociedade Brasileira de Anestesiologia (SBA)
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