Intracuff tracheal tube pressure difference between supine and prone position in intubated patients in the operating room

• Laksono B.H.
• Vitraludyono R.
• Santoso S.H.
• Fatoni A.Z.

Abstract

Using a Cuffed Endotracheal Tube (ETT) is crucial for maintaining airway integrity during positive pressure ventilation and preventing aspiration from subglottic secretions. Alterations in patient positioning may influence the intracuff pressure of the ETT, which can significantly impact patient outcomes.

Aim. This study’s aim is to investigate the impact of supine and prone positioning changes on ETT pressure of intubated patients in the operating room.

Patients and methods. Thirty patients aged 18–65 who underwent surgery under general anesthesia were selected for the study. After endotracheal intubation, cuff ETT is developed with minimal occlusive volume techniques. ETT is placed on the right side of the mouth. Changes in ETT intracuff pressure are assessed in supine and prone positions.

Result. A statistically significant variance in intracuff pressure was observed between supine and prone positions (p=0.000), shifting from 24.70±1.15 to 26.17±0.98 cm H₂O. Employing a minimal occlusive volume method with an inflation volume of 10 cc can increase ETT intracuff pressure within the range of 23 to 28 cm H₂O (with the normal range being 20–30 cm H₂O).

Conclusion. ETT intracuff pressure was significantly higher after the position change from the supine to the prone position. 

Keywords: endotracheal tube (ETT); prone; supine; ETT pressure; general anesthesia; ventilation

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