Max pressure on an intubation cuff

[essedus]

Hello all. I could not find in neither my med-surg nor my fundamentals book the maximum pressure of a cuff on an endotracheal or tracheostomy tube. Also I saw some readings on the net in mmHg and mmH2o and was wondering how they compare. Please let me know what the appropriate pressure is and if possible please cite your sources.

Thanks a bunch.

[TazziRN, RN]

10 mls. No sources, just years of experience. It's not always 10 that's inserted, but that's the max.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I don't think I've ever heard or seen anyone refer to "pressure" on an ET cuff?? It's usually 10ml. Maybe I misunderstanding the question?

[essedus]

TazziRN and RN-Cardiac. Thank you both for responding. It is important to know that the volume is 10mL, I actually did not know that. However I did stumble upon the question about pressure in one of the tests I was taking for an agency a month ago, the options were offered in mmHg and I did find minimal info online but I do not trust sources I do not know, anyone can put up a web page claiming anything they like.

[TazziRN, RN]

All you do is pull up 10 ml of air into a 10-ml syringe, hook it up to the cuff port, and inject the air. I don't know where mmHg comes into that. There is no mercury anywhere near the cuff.

[fakebee]

I think it's 24 mmHg pressure thats the max as read by a cuff manometer. I'll check with an RT when I work tomorrow and post again.

[TazziRN, RN]

Ah........must be something measured when the pt's admitted.

[fakebee]

While you do put 10 mls of air when initially inflating the cuff of an ett,

you have to periodically check the pressure placed on the vocal cords by the cuff by using a manometer attached to the pilot balloon. If the pressure is too high, you risk damage to the cords, too low and a pt doesn't get their tidal volumes. We check the pressure every 8 hours minimum.

[TazziRN, RN]

I work ER. We usually don't have pts that long.

[RRTM2]

]From Egan's Fundamentals of Respiratory Care:

]cuff pressure - between 20 and 25mmHg, or 25 and 30cmH20

[Creamsoda, ASN, RN]

Our RT's measure cuff pressures once a shift with the dealy that they attach.

[berry]

10 mls is placing way too much pressure most people will seal with 4-6 ml of air. Tracheal necrosis and stenosis may result from inflation of endotracheal tube cuffs (ETTc) to pressures >15-25 cm H2O, at which capillary perfusion pressure is exceeded