Background. Both under- and overinflation of endotracheal tube cuffs can result in significant harm to the patient. The optimal\ntechnique for establishing and maintaining safe cuff pressures (20ââ?¬â??30cmH2O) is the cuff pressure manometer, but this is not widely\navailable, especially in resource-limited settings where its use is limited by cost of acquisition and maintenance. Therefore, anesthesia\nproviders commonly rely on subjective methods to estimate safe endotracheal cuff pressure. This study set out to determine the\nefficacy of the loss of resistance syringe method at estimating endotracheal cuff pressures. Methods. This was a randomized clinical\ntrial. We enrolled adult patients scheduled to undergo general anesthesia for elective surgery at Mulago Hospital, Uganda. Study\nparticipants were randomized to have their endotracheal cuff pressures estimated by either loss of resistance syringe or pilot balloon\npalpation. The pressures measured were recorded. Results. One hundred seventy-eight patients were analyzed. 66.3% (59/89) of\npatients in the loss of resistance group had cuff pressures in the recommended range compared with 22.5% (20/89) from the pilot\nballoon palpation method. This was statistically significant. Conclusion.The loss of resistance syringe method was superior to pilot\nballoon palpation at administering pressures in the recommended range. This method provides a viable option to cuff inflation.
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