A patient undergoes prolonged intubation in the ICU. The nurse notes the endotracheal tube cuff pressure is 45 cm H2O. What is the recommended range for cuff pressure to prevent tracheal mucosal ischemia?

• A 5-10 cm H2O
• B 20-30 cm H2O ✓
• C 40-50 cm H2O
• D 60-70 cm H2O

Explanation

The recommended endotracheal tube cuff pressure is 20-30 cm H2O. Pressures above 30 cm H2O can cause tracheal mucosal ischemia, potentially leading to tracheal stenosis, necrosis, or tracheoesophageal fistula. Pressures below 20 cm H2O increase the risk of aspiration and inadequate ventilation. Cuff pressure should be measured regularly in intubated patients.

Reference: Miller's Anesthesia, 9th ed.

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Written and medically reviewed by the StethoPrep medical team.