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Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentation 2 - Care Equity, Quality and Safety

Endotracheal Tube Cuff Pressure Assessment in a Large Academic Medical Center

Monday, October 13, 2025
8:30 AM - 8:36 AM EDT
Location: 107-108
Disclosure(s):
Hannah L. Kavookjian, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Naomi C. Wang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Endotracheal tube (ETT) cuff pressures that fall outside recommended parameters can contribute to and/or cause harm to intubated patients. Reliable assessment tools are necessary to help mitigate this potential harm.

Methods: This quality improvement project took place Aug-Nov 2024. Adult patients with ETTs included. Respiratory therapists (RT) attended an information session explaining the intervention and instructions for using the Medline AG Cuffill to measure cuff pressure. Two weeks of pre-intervention data were collected, followed by 2 weeks of post-intervention data. RTs were instructed to measure cuff pressures at least once per 12-hour shift with the Cuffill, and to inflate/deflate the cuff to ensure pressure readings between 20-30 cm H2O throughout the respiratory cycle. The primary outcome was the number of cuffs within the goal range. Secondary outcome measures were length of intubation, length of hospitalization, and rates of ventilator associated pneumonia (VAP).

Results: A total of 244 measurements were taken from 105 patients. There was no significant difference in the percentage of cuffs checked daily by RT (p=0.4516). We observed a significant increase of in-range cuffs: pre-intervention 12%, post-intervention 27% of cuffs (p=0.006). Median cuff values pre-intervention were significantly higher than the median cuff values post-intervention (p < 0.0001). The number of extremely over-pressured cuffs (>99 cm H20) decreased from 12% of cuffs to 2% of cuffs (p=0.001). Overinflation (>30 cm H20) decreased from 48% of cuffs to 12% of cuffs (p < 0.0001). Underinflation increased post-intervention from 40% of pre-intervention cuffs to 63% post-intervention cuffs (p < 0.001). There was no significant difference in Ventilator-Associated Pneumonia (VAP) between pre- and post-intervention groups (p=0.721).

Conclusions: The use of the Cuffill by RTs increases the number of ETT Cuffs within a safe range. This study adds to the growing body of evidence that objective ETT cuff pressure measurements improve patient care by reducing rates of ventilator associated pneumonia and laryngotracheal injury.

    Presenting Author(s)

  • AK

    Angela L. Kaczorowski-Worthley, Other

    Medical Student
    University of Kansas School of Medicine
    Lenexa, KS, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Hannah L. Kavookjian, MD

    Assistant Professor
    University of Kansas Medical Center
    Kansas City, KS, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Presenting Author(s)

  • Jennifer Diebolt, MD

    Resident
    University of Kansas Medical Center
    Kansas City, Kansas, United States

    Disclosure information not submitted.

    • Co-Author(s)

  • Jennifer Diebolt, MD

    Resident
    University of Kansas Medical Center
    Kansas City, Kansas, United States

    Disclosure information not submitted.

  • ES

    Emma Starr, B.S.

    University of Kansas School of Medicine
    Bucyrus, Kansas, United States

    Disclosure information not submitted.

  • BC

    Brooklyn Q. Campbell, B.S.

    University of Kansas School of Medicine
    TOPEKA, Kansas, United States

    Disclosure information not submitted.

  • CK

    Carli A. Kennedy, MBA, RRT-NPS, C-NPT

    Clinical Specialist
    University of Kansas Medical Center
    Kansas City, Missouri, United States

    Disclosure information not submitted.

  • BH

    Brett Haberly, RRT

    Respiratory Therapy Clinical Specialist
    University of Kansas Medical Center, United States

    Disclosure information not submitted.

    • Presenting Author(s)

  • Naomi C. Wang, MD

    Resident
    University of Kansas Medical Center Department of Otolaryngology– Head & Neck Surgery
    Kansas City, MO, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Naomi C. Wang, MD

    Resident
    University of Kansas Medical Center Department of Otolaryngology– Head & Neck Surgery
    Kansas City, MO, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Frank T. Materia, PhD, MHS

    Assistant Professor
    University of Kansas Medical Center
    Kansas City, Kansas, United States

    Disclosure information not submitted.

  • RW

    Robert Wright, Other

    University of Kansas Department of Otolaryngology, United States

    Disclosure information not submitted.