Endotracheal Tube Cuff Inflation Pressure Varieties and Response to Education Among Anesthetists

Study Overview
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Brief Summary
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Cuff pressure is essential in endotracheal tube management. Guidelines recommend a cuff pressure of 20 to 30 cm H2O. One study, for instance, found that cuff pressure exceeded 40 cm H2O in 40-to-90% of tested patients. This study will investigate the endotracheal ETT cuff inflation pressure applied by the participating anaesthetists, and their response after being informed about the pressure the participants will apply.

Detailed Description
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Although the increasing uses of different supraglottic devices as an alternative, the traditional endotracheal intubation is still considered the commonly used method for managing the airway of a generally anaesthetized patient. After passing the endotracheal tube through the larynx, the anaesthetist inflates the cuff or asks the anaesthesia technician to inflate it. How much air is injected into the cuff is not a major concern for almost all anaesthetists and they usually depend on palpating the external cuff tense to judge is it too much, accurate or not enough? Cuff pressure is essential in endotracheal tube management. Guidelines recommend a cuff pressure of 20 to 30 cm H2O. Inflation of the cuff of pressure more than 30 cm H2O can damage the tracheal mucosa by compromising capillary perfusion. When pressures are greater than 50 cm H2O, total obstruction of tracheal blood flow occurs. For long times, without any evidence-based data, it has been believed that well-trained anaesthetists are capable of determining proper ETT cuff pressures. It is presumed that anaesthetists can detect appropriate inflation pressure and overinflated ETT cuff by palpating the ETT pilot balloon. Adequacy of cuff inflation is conventionally determined by palpation of the external balloon. Previous studies suggest that this approach is unreliable. One study, for instance, found that cuff pressure exceeded 40 cm H2O in 40-to-90% of tested patients. However, increased awareness of over-inflation risks may have improved recent clinical practice. The aim of the work: This study will investigate the endotracheal cuff inflation pressure applied by the participating anaesthetists, and their response after being informed about the pressure the participants will apply. Material and Methods: Type of the study: Prospective controlled single-blind study. Settings: After obtaining approval by the Ethics Committee of the Suez Canal University Hospital, and written informed consent with an explanation regarding the purpose, effects, technique, and complications, all anaesthetists, working currently in the facility, are included.

Official Title
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Endotracheal Tube Cuff Inflation Pressure Varieties and Response to Education Among Anesthetists

Conditions
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Endotracheal Tube

Intervention / Treatment
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* Behavioral: Before the education program
* Behavioral: After the education program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: anaesthetists works at Suez canal university hospital resident, registrar, or senior registrar Exclusion Criteria: refusal to participate who will not complete the 2 rounds 3 readings each
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Interventional Model Description: anaesthetists of anaesthesia department on Suez canal university
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Before education<br>Before alarming the participant anaesthetists about the pressure values of their practice in inflating the ETT cuff. This is before applying the intervention which is informing and educating the participant anaesthetists about the proper ETT cuff pressure. | Behavioral: Before the education program<br>* Before applying the education program of the endotracheal cuff pressure inflation to the participating anaesthetists.<br>|
| Active Comparator: After education<br>After alarming the participant anaesthetists about the pressure values of their practice in inflating the ETT cuff. This is after applying the intervention which is informing and educating the participant anaesthetists about the proper ETT cuff pressure. | Behavioral: After the education program<br>* After applying the education program of the endotracheal cuff pressure inflation to the participating anaesthetists.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| accuracy in inflating the cuff of the endotracheal tubes | assessment of the Anesthetists' accuracy in inflating the cuff of the endotracheal tubes used to maintain the airway of generally anaesthetized patients the change following feedback. | immediately after fixation of the endotracheal tube during general anaethesia |