Endotracheal Tube Cuff Pressure Is Unpredictable in Children

The use of cuffed tracheal tubes in children younger than 8 yr of age has recently increased, although cuff hyperinflation may cause tracheal mucosal damage. In this study, we sought to measure the cuff pressure (Pcuff) after initial free air inflation (iPcuff) and to follow its evolution throughout the duration of 50 % nitrous oxide (N2O) anesthesia. One-hundred-seventy-four children, aged 0 to 9 yr, fulfilling the following criteria, were studied: 1) weight of 3–35 kg; 2) ASA physical sta-tus I or II; 3) elective surgery; 4) anesthesia with tracheal intubation using a cuffed tube and lasting at least 45 min; and 5) gas mixture containing 50 % N2O. Free air inflation results in variable iPcuff, with hyperinflation in 39 % of cases. Numerous gas removals were required to maintain Pcuff less than 25 cm H2O in 85 % of the pa