Effect of Head Position Change on Endotracheal Cuff Pressure in Mechanically Ventilated Patients: A Quasi-Experimental Study

Document Type : Original Article


1 Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran,

2 Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran,

3 Department of Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran


Background: Endotracheal cuff pressure may be affected by various factors and interventions. Therefore, this study was conducted to investigate the effect of head position change on cuff pressure of the endotracheal tube whilst undergoing mechanical ventilation.
Materials and Methods: In this semi-experimental study, 61 intubated patients undergoing mechanical ventilation were studied. Each subject was used as their own control group. First, each patient was placed in starting position and the cuff pressure was adjusted in the range of 20-30 cmH2O. Then, the head position was placed in anterior flexion, hyperextension, left lateral flexion, right lateral flexion, left rotation, and right rotation without separating the manometer from the pilot cuff. The cuff pressure was recorded and analyzed at each stage.
Results: The endotracheal cuff pressure increased in all six head positions. The highest difference in pressure was observed in the anterior flexion and left rotation positions (p <0.001). The observed increases in cuff pressure were higher than the normal range (30 cmH2O) in a significant number of patients.
Conclusion: Changing the head position in mechanically ventilated patients increases endotracheal cuff pressure. Therefore, it is suggested that the cuff pressure should be re-examined and adjusted after each head position change while avoiding unnecessary movements of the head and neck of the intubated patients.