Discussion
The cuff during mechanical ventilation seals the airway, the endotracheal cuff pressure of 20 to 30 cmH2O is adequate for most patients, but lack of a tracheal seal still occurs in a small number of people[9, 10]. Similarly, the airway in our case can be completely sealed when the cuff pressure of endotracheal intubation reaches 100 cmH2O. The diagnosis was made by the patient’s chest CT(X-ray computed tomography), Main findings that the real cross-sectional area of airway was significantly larger than cross-sectional area of cuff. This case illustrates that the real cross-sectional area of airway from the case obviously exceeds the normal population and the importance of rapid the patient’s chest CT diagnosis to prevent mismatch cuff with airway, to select the cuff of endotracheal tube matching with the patient’s airway.
Consensus suggests that cuff pressure in endotracheal tubes should range from 20 to 30 cmH2O[11]. Excessively high or low cuff pressures have been associated with complications such as tracheal stenosis, leaking of tidal volume, microaspiration of secretions, and ventilator-associated pneumonia[12]. As can be seen from Fig1, Compared with cross-sectional area of cuff, the real cross-sectional area of trachea was significantly larger; so that the cuff pressure is 100 cmH2O, the cuff of endotracheal intubation can seal the airway. Referring to the consensus of experts, patients are prone to ventilator-associated pneumonia.