Could clinical nursing procedures lead to tracheal cuff pressure drop? A prospective observational study

Aim To evaluate the dynamic changes in tracheal cuff pressure before and after four clinical nursing procedures including sputum suction, oral care, atomisation inhalation, and turning over, and thus provide references for the adjustment time of cuff pressure in clinical practice. Background Cuff pressure must be kept within the range of 25–30 cmH2O to ensure effective ventilation and prevent aspiration, while maintaining tracheal blood flow perfusion. Design A prospective observational study. Methods The cuff pressure of 56 intubated patients was adjusted to 28–30 cmH2O. A cuff pressure monitor was used to continuously monitor cuff pressure changes before and after four clinical nursing procedures (sputum suction, oral care, atomisation inhalation, and turning over) and the cuff pressures at various time points were compared. The semi‐quantitative cough strength score (SCSS) was used to evaluate cough strength during sputum suction and the effect of cough strength on cuff pressure during sputum suction. This study followed the STROBE checklist for cross‐sectional studies. Results The cuff pressures during the four clinical nursing procedures of sputum suction, atomisation inhalation, turning over, and oral care, all temporarily increased (p