Cuff overinflation and endotracheal tube obstruction : case report and experimental study

  • Background: Initiated by a clinical case of critical endotracheal tube (ETT) obstruction, we aimed to determine factors that potentially contribute to the development of endotracheal tube obstruction by its inflated cuff. Prehospital climate and storage conditions were simulated. Methods: Five different disposable ETTs (6.0, 7.0, and 8.0 mm inner diameter) were exposed to ambient outside temperature for 13 months. In addition, every second of these tubes was mechanically stressed by clamping its cuffed end between the covers of a metal emergency case for 10 min. Then, all tubes were heated up to normal body temperature, placed within the cock of a syringe, followed by stepwise inflation of their cuffs to pressures of 3 kPa and >=12 kPa, respectively. The inner lumen of the ETT was checked with the naked eye for any obstruction caused by the external cuff pressure. Results: Neither in tubes that were exposed to ambient temperature (range: -12°C to +44°C) nor in those that were also clamped, visible obstruction by inflated cuffs was detected at any of the two cuff pressure levels. Conclusions: We could not demonstrate a critical obstruction of an ETT by its inflated cuff, neither when the cuff was over-inflated to a pressure of 12 kPa or higher, nor in ETTs that had been exposed to unfavorable storage conditions and significant mechanical stress.

Download full text files

Export metadata

Author:Christian Hofstetter, Bertram SchellerORCiDGND, Sandra Hoegl, Martin G. Mack, Bernhard ZwißlerGND, Christian ByhahnGND
Pubmed Id:
Parent Title (English):Scandinavian journal of trauma, resuscitation and emergency medicine
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Date of Publication (online):2010/04/26
Date of first Publication:2010/04/08
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2010/04/26
Issue:Art. 18
Page Number:5
First Page:1
Last Page:5
© 2010 Hofstetter et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Source:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2010, 18:18 ; doi:10.1186/1757-7241-18-18 ;
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 2.0