A Review of Clinical Protocols for Cuff Management in Adult Patients with an Artificial Airway in Chilean Hospitals

Abstract

Previous research carried out in Chile reports that some health institutions have developed their own protocols for the management of adult patients with an artificial airway. These protocols recommend different cuff pressures, which could result in risks for the patients. There is no guideline by the Chilean Ministry of Health on this topic; furthermore, it has been observed that health professionals in Chile use inadequate cuff pressures with patients. The objective of this study was to describe the techniques and cuff pressures recommended in the protocols of Chilean public hospitals for the management of adult patients with an artificial airway. Secondary research was conducted using a descriptive design that included valid protocols used for the management of adult patients with an artificial airway in Chilean public hospitals. The project was approved by an Ethics Research Committee. The results of this study showed that most of the protocols mentioned the use of an objective technique with patients; however, they failed to mention the specific instrument. The mean minimum pressure reported in the protocols was 28.44 cmH2O, whilst the mean maximum pressure was 36.12 cmH2O. Only 23.80% of the protocols complied with the pressure values recommended by the current evidence. In conclusion, most of the analyzed protocols mention the use of an objective technique, with 68.75% of them recommending cuff pressures that exceed safe values. This could compromise the adequate care of patients during hospitalization. It is crucial that institutional protocols are updated and that the Ministry of Health develops a national guideline that provides clear instructions on this practice