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The cuff should not be at a pressure greater than 30 mmHg, over that pressure, tissue necrosis can occur because it reduces blood flow to the tracheal mucosa. There should be a manometer that the respiratory therapists can check it with, you can use it too since it usually stays close to the ventilator. With that in mind, a safe bet is to only inflate the cuff with enough air to prevent a leak.
I use MOV (Minimal Occluding Volume) Technique most of the time...
Inflate the cuff until no leak is heard. Then let a bit of air out until a tiny leak is audible (you have to be fairly close to hear). Then add just enough to stop the leak.
This is enough to maintain tidal volumes/PEEP but prevent tissue damage. Same for trachs.
The manometer gives an actual reading but it's not easy to use. It's difficult to maintain the pressure
you've just adjusted and verified while attaching to ports. Or maybe that's just me. :)
Our Docs like it to be at 20mmHg.
One thing I've learned through experience... if I've put a lot of air in the cuff and still have a leak,
the most likely cause is the ETT has moved up the trachea and getting ready to come out.
That's what I check first anyway, before I say the ETT is too small for the Pt, or think about tracheomalacia (collapsed cartilage from prolonged intubation).
Possum
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How much air do u putt in the ETT cuff? say a size 7 Adult ETT. When the cuff says 30 on the air port??