• Gustavo A Plotnikow, Nicolas Roux, Viviana Feld, Emiliano Gogniat, Dario Villalba, Noelia Vairo Ribero, Marisa Sartore, Mauro Bosso, Corina Quiroga, Valeria Leiva, Mariana Scrigna, Facundo Puchulu, Eduardo Distéfano, Jose Luis Scapellato, Dante Intile, Fernando Planells, Diego Noval, Pablo Buñirigo, Ricardo Jofré, and Ernesto Díaz Nielsen.
• Respiratory Care Services, Clínica Basilea, Argentina ; Intensive Care Unit, Sanatorio Anchorena, Buenos Aires, Argentina.
• Int J Crit Illn Inj Sci. 2013 Oct 1; 3 (4): 262-8.

BackgroundMost of the studies referring cuff tubes' issues were conducted on intubated patients. Not much is known about the cuff pressure performance in chronically tracheostomized patients disconnected from mechanical ventilation.ObjectiveTo evaluate cuff pressure (CP) variation in tracheostomized, spontaneously breathing patients in a weaning rehabilitation center.Materials And MethodsExperimental setup to test instruments in vitro, in which the gauge (TRACOE) performance at different pressure levels was evaluated in six tracheostomy tubes, and a clinical setupin which CP variation over 24 h, every 4 h, and for 6 days was measured in 35 chronically tracheostomized clinically stable, patients who had been disconnected from mechanical ventilation for at least 72 h. The following data were recorded: Tube brand, type, and size; date of the tube placed; the patient's body position; the position of the head; axillary temperature; pulse and respiration rates; blood pressure; and pulse oximetry.ResultsIn vitro difference between the initial pressure (IP) and measured pressure (MP) was statistically significant (P < 0.05). The difference between the IP and MP was significant when selecting for various tube brands (P < 0.05). In the clinical set-up, 207 measurements were performed and the CP was >30 cm H2O in 6.28% of the recordings, 20-30 cm H2O in 42.0% of the recordings, and <20 cm H2O in 51.69% of the recordings.ConclusionThe systematic CP measurement in chronically tracheostomized, spontaneously breathing patients showed high variability, which was independent of tube brand, size, type, or time of placement. Consequently, measurements should be made more frequently.

6 keywords...

hide…