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This study is aimed at establishing whether use of loss of resistance syringe (LOR) that is traditionally used for identifying epidural space, is a better method for providing safe cuff pressures in adults intubated with cuffed endotracheal tubes. The conventional method is the use of pilot ballon palpation (PBP) to approximate cuff pressures but this is associated with airway damage.
The study hypothesis states that both the loss of resistance syringe method and the pilot balloon palpation methods achieve the recommended endotracheal tube intracuff pressures.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 2. LOR and aneroid manometer group | Experimental | after inflating the endotracheal tube (ETT) cuff using a loss of resistance syringe (BD Epillor LOR), the LOR syringe is left attached to the pilot balloon and and any excess pressure will be passively released until the plunger stops drawing back. |
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| 1. PBP and aneroid manometer group | Placebo Comparator | The anaesthesia care provider shall inflate the ETT cuff via the pilot balloon with small volumes of air as he/she 'feels ' for the pressures in the pilot balloon to a pressure he/she thinks is just enough. An aneroid manometer (VBM, Germany. Accurate in the range 0-120 cmH2O +-2 cmH2O) shall then be attached by the investigator and measurement of the pressure taken. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PBP | Device | the pilot balloon is continuously palpated o felt for adequate pressure as its being inflated. |
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| Measure | Description | Time Frame |
|---|---|---|
| The percentage of subjects with intracuff pressure ranging from 20cm H2O to 30cmH2O | This outcome will be measured within the first 5 minutes after intubation of the patient. The recommended range of intracuff pressure for this study is 20-30cmH2O | 5minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of early postoperative airway symptoms | Patents will be reviewed 12 hours after extubation for cough, sore throat, dysphagia and dysphonia. | 12 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Fred Bulamba, masters | Anaesthesiologist | Principal Investigator |
| Kintu Andrew, Fellowship | Lecturer | Study Chair |
| Arthur Kwizera, Masters | Lecturer | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Makerere University college of health sciences, Mulago National Referal Hospital Complex | Kampala | 256 | Uganda |
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| LOR | Device |
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| Aneroid manometer | Device | The pilot balloon is attached onto the manometer and cuff pressures are raed off from the gauge. |
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