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Evaluation of a Novel Device to Determine Tracheotomy Tube Cuff Pressure

At the conclusion of this presentation, the participants should be able to understand the ability of the PressureEasy® Cuff Pressure Controller to monitor tracheotomy tube cuff pressure. Objectives: Elevated tracheotomy tube cuff pressures can cause long-term damage to the trachea. Tighter control of cuff pressures may prevent morbidity in tracheotomized patients. The purpose of this study is to evaluate the accuracy of the PressureEasy® Cuff Pressure Controller (Medex, Carlsbad, CA) to monitor tracheotomy tube cuff pressures. Study Design: Prospective. Methods: The PressureEasy® Cuff Pressure Controller (PEC) contains a green indicator to signify a cuff pressure between 20 and 30 cm H2O (see Figure 1). The tracheotomy tube cuffs were inflated to the reference points on the PEC designated for 20 and 30 cm H2O pressure and the actual pressure was determined by a standard pressure gauge (SPG). The tracheotomy tube cuffs were reinflated to the midpoint between 20 and 30 cm H2O pressure on the PEC and the pressure was measured using the SPG at time zero (T0). Pressures were recorded again at 2 minutes (T2). Portex 7.0, 8.0, and 9.0 cuffed tracheotomy tubes (Smiths Medical – Portex Inc., Keene, NH) were used as in a previously established tracheal model. Four PEC devices were tested. Results: When the green indicator line was set at 30 cm H2O on the PEC, the average pressure reading on the SPG was 30.3±1.2 cm H2O. With the indicator set at 20 cm H2O on the PEC, the SPG average pressure reading was 20.9±0.8 cm H2O. Once the indicator was set at the midpoint, the average pressure readings by the SPG at T0 were 27.4±0.8, 27.4±0.7, and 27.7±0.8 cm H2O (27.5±0.7 overall) in the Portex 7.0, 8.0, and 9.0 tracheotomy tubes, respectively. The difference between these readings and the PEC were statistically significant (p < 0.05). At T2, the average readings by the PEC were 24.3±1.2, 23.0±1.6, and 23.8±1.0 cm H2O (23.7±1.3 overall), compared to 25.1±1.8, 23.9±1.8, and 24.6±1.6 cm H2O (24.5±1.7 overall) by the SPG (p > 0.05). One-hundred percent (48/48) of all pressure readings were between 20 and 30 cm H2O when the indicator was set at the midpoint at both T0 and T2. Conclusions: The PressureEasy® Cuff Pressure Controller provides reliable estimates of tracheotomy tube cuff pressures between 20 and 30 cm H20 in the simulated tracheal model. EVALUATION OF A NOVEL DEVICE TO DETERMINE TRACHEOTOMY TUBE CUFF PRESSURE