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.