n Southern African Journal of Critical Care - Endotracheal tube cuff pressures - still a problem! : editorial




Endotracheal intubation for mechanical ventilation has a central role in the intensive care unit (ICU), but is associated with numerous complications. One serious - but largely preventable - complication is tracheal stenosis, secondary to excessive pressure in the cuff of the endotracheal or tracheostomy tube. The high pressure in the cuff compresses the mucosa against the rigid tracheal cartilage rings, resulting in mucosal damage and ischaemic necrosis. Fibrotic healing of this lesion leads to the gradual stenosis of a section of the trachea. Patients may present weeks to months after discharge from the ICU when obstruction in the trachea reaches a critical degree. Stenosis may also make subsequent intubation of the trachea impossible. Other complications of high cuff pressure (Pcuff ) range from frequent sore throat to rare but disastrous events such as tracheo-oesophageal fistula.


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