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Effects of Head and Neck Position on Nasotracheal Tube Intracuff Pressure: A Prospective Observational Study

 Hye Jin Kim  ;  Jaewon Jang  ;  So Yeon Kim  ;  Wyun Kon Park  ;  Hyun Joo Kim 
 JOURNAL OF CLINICAL MEDICINE, Vol.10(17) : 3910, 2021-08 
Journal Title
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To prevent endotracheal tube-related barotrauma or leakage, the intracuff pressure should be adjusted to 20–30 cm H2O. However, changes in the nasotracheal tube intracuff pressure relative to neck posture are unclear. In this study, we investigated the effect of head and neck positioning on nasotracheal tube intracuff pressure. Fifty adult patients with nasotracheal tubes who were scheduled for surgery under general anesthesia were enrolled. Following intubation, intracuff pressure was measured by connecting the pilot balloon to a device that continuously monitors the intracuff pressure. Subsequently, the intracuff pressure was set to 24.48 cm H2O (=18 mmHg) for the neutral position. We recorded the intracuff pressures based on the patients’ position during head flexion, extension, and rotation. The initial intracuff pressure was 42.2 cm H2O [29.6–73.1] in the neutral position. After pressure adjustment in the neutral position, the intracuff pressure was significantly different from the neutral to flexed (p < 0.001), extended (p = 0.003), or rotated (p < 0.001) positions. Although the median change in intracuff pressure was <3 cm H2O when each patient’s position was changed, overinflation to >30 cm H2O occurred in 12% of patients. Therefore, it is necessary to adjust the intracuff pressure after tracheal intubation and each positional change.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Kim, Hyun Joo(김현주) ORCID logo https://orcid.org/0000-0003-1963-8955
Kim, Hye Jin(김혜진) ORCID logo https://orcid.org/0000-0003-3452-477X
Park, Wyun Kon(박윤곤)
Jang, Jaewon(장재원) ORCID logo https://orcid.org/0000-0002-1997-8733
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