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<p>Cuffed endotracheal tubes (ETTs) are widely used in general anesthesia, with recommended cuff pressure (CP) between 20 and 30 cmH<sub>2</sub>O in adults. This multi-center study investigated actual CP management practices across 19 Grade A tertiary hospitals in China, involving 2058 anesthetized patients. The median initial CP measured within 30&#xa0;min post-intubation was 48 cmH<sub>2</sub>O (IQR 32–70), with only 19% within the recommended range (75.4% &gt; 30 cmH<sub>2</sub>O; 5.6% &lt; 20 cmH<sub>2</sub>O). All institutions demonstrated similarly suboptimal CP management. Four distinct methods were used for cuff pressure estimation: pilot balloon palpation (96.2%), fixed-volume inflation (2.8%), minimal occlusive volume technique (0.7%), and direct manometry (0.2%). Among them, only direct manometry demonstrated reliable accuracy in achieving appropriate pressures. The remaining three methods showed no clear superiority over one another in terms of pressure assessment accuracy. In orotracheally intubated patients with palpation-estimated CP, independent risk factors for elevated pressure (&gt; 30 cmH<sub>2</sub>O) included: age &lt; 60 years, pressure-controlled ventilation, absence of PEEP, ETT internal diameter &lt; 7.0&#xa0;mm, aminosteroid neuromuscular blocker use, and trainee-performed inflation. These findings highlight widespread challenges in optimal CP management across Chinese tertiary care centers.</p>

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The investigation of initial endotracheal tube cuff pressures in the operating room: a multi-center cross-sectional study in China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月1日

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  • Heqi Peng,
  • Zhaohui Tang,
  • Yalin Li,
  • Wei Zhang,
  • Kaiming Duan,
  • Hong Zheng,
  • Lulong Bo,
  • Yilin Zheng,
  • Peng Wu,
  • Jiaxin Tian,
  • Yajuan Han,
  • Xiaohua Zou,
  • Gang Chen,
  • Jun Xu,
  • Jianqiang Guan,
  • Xuezheng Zhang,
  • Jianliang Sun,
  • Yuekun Shen,
  • Mao Zhou,
  • Shu Zheng,
  • Hui Wang,
  • Hongmei Ma,
  • Qulian Guo,
  • Wangyuan Zou,
  • Yingqi Weng

摘要

Cuffed endotracheal tubes (ETTs) are widely used in general anesthesia, with recommended cuff pressure (CP) between 20 and 30 cmH2O in adults. This multi-center study investigated actual CP management practices across 19 Grade A tertiary hospitals in China, involving 2058 anesthetized patients. The median initial CP measured within 30 min post-intubation was 48 cmH2O (IQR 32–70), with only 19% within the recommended range (75.4% > 30 cmH2O; 5.6% < 20 cmH2O). All institutions demonstrated similarly suboptimal CP management. Four distinct methods were used for cuff pressure estimation: pilot balloon palpation (96.2%), fixed-volume inflation (2.8%), minimal occlusive volume technique (0.7%), and direct manometry (0.2%). Among them, only direct manometry demonstrated reliable accuracy in achieving appropriate pressures. The remaining three methods showed no clear superiority over one another in terms of pressure assessment accuracy. In orotracheally intubated patients with palpation-estimated CP, independent risk factors for elevated pressure (> 30 cmH2O) included: age < 60 years, pressure-controlled ventilation, absence of PEEP, ETT internal diameter < 7.0 mm, aminosteroid neuromuscular blocker use, and trainee-performed inflation. These findings highlight widespread challenges in optimal CP management across Chinese tertiary care centers.