Changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms: an observational prospective clinical trial

Abstract Background Laparoscopic surgery is a popular alternative for resection of colorectal neoplasms. Carbon dioxide pneumoperitoneum and Trendelenburg positioning in procedure can significantly increase airway pressure, when endotracheal tube cuff pressure is not monitored. This prospective obse...

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Main Authors: Shenquan Cai, Xuan Wang, Jie Zhang, Guangli Zhu, Chenyao Jian, Shanwu Feng, Manlin Duan
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Anesthesiology
Subjects:
Online Access:https://doi.org/10.1186/s12871-024-02802-4
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author Shenquan Cai
Xuan Wang
Jie Zhang
Guangli Zhu
Chenyao Jian
Shanwu Feng
Manlin Duan
author_facet Shenquan Cai
Xuan Wang
Jie Zhang
Guangli Zhu
Chenyao Jian
Shanwu Feng
Manlin Duan
author_sort Shenquan Cai
collection DOAJ
description Abstract Background Laparoscopic surgery is a popular alternative for resection of colorectal neoplasms. Carbon dioxide pneumoperitoneum and Trendelenburg positioning in procedure can significantly increase airway pressure, when endotracheal tube cuff pressure is not monitored. This prospective observational study aimed to evaluate indicators, changes and its correlation factors of endotracheal tube cuff pressure during laparoscopic resection of colorectal neoplasms. Methods 122 patients scheduled for laparoscopic resection of colorectal neoplasms under propofol/remifentanil total intravenous anesthesia with orotracheal intubation were included. Tracheal tube cuff pressure was monitored continuously by calibrated pressure transducers. The ability of several predictors to predict out-of-range tracheal tube cuff pressure at different time points and its correlation factors were assessed. Results ROC analysis showed that waist-to-hip ratio has the highest AUC for predicting out-of-range tracheal cuff pressure (AUC: 0.86 [95% CI: 0.77–0.95]); Tracheal tube cuff pressure provided by palpation was 41.0 (29.0−53.3) cmH20. Cuff pressure was 33.7 ± 2.9 cmH20 at 15 min and comparable at 30 and 45 min after insufflation, all values were significantly higher than 25 cmH20 (p < 0.001). Multiple linear regression showed tracheal tube cuff pressure was associated with peak airway pressure (p < 0.001). Conclusions Patients with normal BMI undergoing laparoscopic resection of colorectal neoplasms require continuous monitoring and timely adjustments of tracheal tube cuff pressure. Compared with BMI, waist-to-hip ratio is a better predictor of out-of-range tracheal tube cuff pressure. Trial registration Chinese Clinical Trial Registry, identifier: ChiCTR2100054089, Date: 08/12/2021.
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spelling doaj-art-a91a73a156f24bc98ef0b511761fe2e92025-08-20T02:17:02ZengBMCBMC Anesthesiology1471-22532024-11-012411710.1186/s12871-024-02802-4Changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms: an observational prospective clinical trialShenquan Cai0Xuan Wang1Jie Zhang2Guangli Zhu3Chenyao Jian4Shanwu Feng5Manlin Duan6Department of Anesthesiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Anesthesiology, Women’s Hospital of Nanjing Medical University, Women and Children’s HealthCare HospitalDepartment of Anesthesiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Anesthesiology, Li Huili Hospital Affiliated to Ningbo UniversityDepartment of Anesthesiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical UniversityDepartment of Anesthesiology, Women’s Hospital of Nanjing Medical University, Women and Children’s HealthCare HospitalDepartment of Anesthesiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing UniversityAbstract Background Laparoscopic surgery is a popular alternative for resection of colorectal neoplasms. Carbon dioxide pneumoperitoneum and Trendelenburg positioning in procedure can significantly increase airway pressure, when endotracheal tube cuff pressure is not monitored. This prospective observational study aimed to evaluate indicators, changes and its correlation factors of endotracheal tube cuff pressure during laparoscopic resection of colorectal neoplasms. Methods 122 patients scheduled for laparoscopic resection of colorectal neoplasms under propofol/remifentanil total intravenous anesthesia with orotracheal intubation were included. Tracheal tube cuff pressure was monitored continuously by calibrated pressure transducers. The ability of several predictors to predict out-of-range tracheal tube cuff pressure at different time points and its correlation factors were assessed. Results ROC analysis showed that waist-to-hip ratio has the highest AUC for predicting out-of-range tracheal cuff pressure (AUC: 0.86 [95% CI: 0.77–0.95]); Tracheal tube cuff pressure provided by palpation was 41.0 (29.0−53.3) cmH20. Cuff pressure was 33.7 ± 2.9 cmH20 at 15 min and comparable at 30 and 45 min after insufflation, all values were significantly higher than 25 cmH20 (p < 0.001). Multiple linear regression showed tracheal tube cuff pressure was associated with peak airway pressure (p < 0.001). Conclusions Patients with normal BMI undergoing laparoscopic resection of colorectal neoplasms require continuous monitoring and timely adjustments of tracheal tube cuff pressure. Compared with BMI, waist-to-hip ratio is a better predictor of out-of-range tracheal tube cuff pressure. Trial registration Chinese Clinical Trial Registry, identifier: ChiCTR2100054089, Date: 08/12/2021.https://doi.org/10.1186/s12871-024-02802-4Tracheal tube cuff pressureLaparoscopic surgeryPeak airway pressureCalibrated pressure transducersWaist-to-hip ratio
spellingShingle Shenquan Cai
Xuan Wang
Jie Zhang
Guangli Zhu
Chenyao Jian
Shanwu Feng
Manlin Duan
Changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms: an observational prospective clinical trial
BMC Anesthesiology
Tracheal tube cuff pressure
Laparoscopic surgery
Peak airway pressure
Calibrated pressure transducers
Waist-to-hip ratio
title Changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms: an observational prospective clinical trial
title_full Changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms: an observational prospective clinical trial
title_fullStr Changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms: an observational prospective clinical trial
title_full_unstemmed Changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms: an observational prospective clinical trial
title_short Changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms: an observational prospective clinical trial
title_sort changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms an observational prospective clinical trial
topic Tracheal tube cuff pressure
Laparoscopic surgery
Peak airway pressure
Calibrated pressure transducers
Waist-to-hip ratio
url https://doi.org/10.1186/s12871-024-02802-4
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