Effect of Prone Position with Right-sided Head Rotation to Endotracheal Cuff Pressure: A Prospective Observational Study
Keywords:
Endotracheal cuff pressure, prone, head rotationAbstract
Background: Some surgical procedures, for example, spine surgery must be performed in prone position. Prone position causes many physiological changes. The position of endotracheal tube might be displaced. Furthermore, the cuff pressure may change from the original pressure applied in the supine position. Objective: To assess the effect of prone position with right-sided head rotation to endotracheal cuff pressure. Methods: We conducted a prospective observational study of 20 adult patients underwent lumbar spine surgery in prone position. The patients who had cervical spine pathology and limited neck motion were excluded. After the patient was positioned prone with right-sided head rotation, the endotracheal cuff pressure was measured every 5 minutes. The time period that cuff pressure exceeded 30 cmH2 O was recorded. The pressure was adjusted within the range of 20-30 cmH2 O. Results: There were group of 10 patients (50%) who had cuff pressure exceeded 30 cmH2 O at 5 minutes and other group of 10 patients (50%), which cuff pressure gradually increased to more than 30 cmH2 O after 5 minutes. There were not significantly differences of demographic data in both groups.
References
extension alter endotracheal tube position in adults and
children. Can J anesth 2009;56:751-6.
2. Kim D, Jeon B, Son SJ, et al. The changes of endotracheal
tube cuff pressure by the position changes from supine to
prone and the flexion and extension of head. Korean J
Anesthesiol 2015;68:27-31.
3. Minonishi T, Kinoshita H, Hirayama M, et al. The supine to
prone position change induces modification of endotracheal
tube cuff pressure accompanied by the displacement. J Clin
Anesth 2013;25:28-31.
4. Athiraman U, Gupta R, Singh G. Endotracheal cuff pressure
changes with change in position in neurosurgical patients.
Int J Crit Ill Inj Sci 2015;5:237-41.
5. Rello J, Sonora R, Jubert P, et al. Pneumonia in intubated
patients: role of respiratory airway care. Am J Respi Crit Care
Med 1996;154:111-5.
6. Kwee MM, Ho YH, Rozen WM. The prone position during
surgery and its complications: A systematic review and
evidence-based guidelines. Int Surg 2015;100:292-303.
7. Lizy C, Swinnwn W, Labeau S, et al. Cuff pressure of
endotracheal tubes after changes in body position in critically
ill patients treated with mechanical ventilation. Am J Crit Care
2014;23:e1-8.
8. Kako H, Krishma SG, Ramesh AS, et al . The relationship
between head and neck position and endotracheal tube
intracuff pressure in pediatric population. Pediatr Anesth
2014;24:316-21.
9. Khalil AN, Salama MAR, Mohammed YW, Sayed SM. Factors
affecting endotracheal tube cuff pressure measurement:
a review of literature. ARC J Nurs Healthc 2018;4:1-5.
10. Mehta S, Myat MH. The cross-sectional shape and
circumference of the human trachea. Ann R Coll Surg Engl
1984;66:356-8.
11. Nguyen Tu H, Saidi N, Lieutaud T, et al. Nitrous oxide
increases endotracheal cuff pressure and the incidence of
tracheal lesions in anesthetized patients. Anesth Analg
1999;89:187–90.
12. Stanley HT. Nitrous oxide and pressures and volumes of
high-and low-pressure endotracheal-tube cuffs in intubated
patients. Anesthesiology 1975;42:637-40.
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright
Copyright of all articles published in the Thai Journal of Anesthesiology is held by the Thai Journal of Anesthesiology, the Royal College of Anesthesiologists of Thailand. Submission of a manuscript constitutes the authors' agreement that, upon acceptance for publication, copyright of the work is transferred to the Journal. The content and any opinions expressed in published articles are the sole responsibility of the authors and do not necessarily reflect the views of the editorial board or the Royal College of Anesthesiologists of Thailand.
Licensing
All articles are published open access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). Under this license, anyone may copy and redistribute published articles in any medium or format for non-commercial purposes, provided that appropriate credit is given to the authors and to the Thai Journal of Anesthesiology as the original source of publication, a link to the license is included, and the material is not modified in any way. Requests for commercial use or for adaptation of published material should be directed to the editorial office.
Authors' Rights
Although copyright is held by the Journal, authors retain the right to reuse their own published material in their future scholarly works, theses and dissertations, teaching, and academic presentations, and to deposit the final published version (PDF) in institutional or subject repositories or on personal and institutional websites, without embargo, provided that the Thai Journal of Anesthesiology is clearly acknowledged as the original place of publication.