Abstract
Background: The main function of an endotracheal tube (ETT) cuff is to prevent aspiration. High cuff pressure is usually associated with postoperative complications. We tried to compare cuff infl ation guided by pressure volume loop closure (PV-L) with those by just to seal technique (JS) and assess the postoperative incidence of sore throat, cough and hoarseness. Materials and Methods: In a prospective, randomized clinical trial, 100 patients' tracheas were intubated. In the fi rst group (n = 50), ETT cuff infl ation was guided by PV-L, while in the second group (n. = 50) the ETT cuff was infl ated using the JS technique. Intracuff pressures and volumes were measured. The incidence of postoperative cuff-related complications was reported. Results: Demographic data and durations of intubation were comparable between the groups. The use of PV-L was associated with a lesser amount of intracuff air [4.05 (3.7-4.5) vs 5 (4.8-5.5), P < 0.001] and lower cuff pressure than those in the JS group [18.25 (18-19) vs 33 (32-35), P <= 0.001]. The incidence of postextubation cuff-related complications was signifi cantly less frequent among the PV-L group patients as compared with the JS group patients (P <= 0.009), except for hoarseness of voice, which was less frequent among the PV-L group, but not statistically signifi cant (P <= 0.065). Multiple regression models for prediction of intra-cuff pressure after intubation and before extubation revealed a statistically signifi cant association with the technique used for cuff infl ation (P < 0.0001). Conclusions: The study confi rms that PV-L-guided ETT cuff infl ation is an effective way to seal the airway and associates with a lower ETT cuff pressure and lower incidence of cuff-related complications