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Effectiveness of Interventions to Increase Provider Monitoring of Endotracheal Tube and Laryngeal Mask Airway Cuff Pressures.

Previous research demonstrates that monitoring and
adjusting pressures in endotracheal (ET) tubes 30
cm H2O or less and laryngeal mask airways (LMAs)
60 cm H2O or less decrease rates of postoperative
pharyngolaryngeal complications. In this evidencebased
practice project we examined whether a multistep
intervention (departmental education plus reference
cards in operating rooms plus addition of cuff
pressure documentation variable in electronic anesthesia
record) would increase the frequency of providers
monitoring intracuff pressures and decrease
the rate of high intracuff pressures. Before and after
the intervention, we recorded intracuff pressures of
51 ET tubes and 51 LMAs in surgical patients, as well
as providers’ self-reported incidence of monitoring
and adjusting intracuff pressures.
Our multistep intervention increased provider monitoring
of intracuff pressures in ET tubes (77% pre- vs
94% postintervention, P = .025) and LMAs (37% pre- vs
94% postintervention, P < .001). Mean ET tube and
LMA cuff pressures were significantly lower postintervention:
ET tube: pre = 34 ± 16 cm H2O vs post = 29
± 12 cm H2O (P = .045), LMA: pre = 73 ± 30 cm H2O vs
post = 49 ± 15 cm H2O (P < .001). Our multistep intervention
improved compliance with intracuff pressure
recommendations.