{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:17:04Z","timestamp":1777933024556,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2025,2]]},"abstract":"\n Background:<\/jats:title>\n In pediatric patients, the intracuff pressure of endotracheal tubes should be as low as possible to prevent injury to the tracheal mucosal wall. The conventional stethoscope-guided technique relies solely on the operator\u2019s sensitivity of audible detection, which may lead to increased intracuff pressure. This study was conducted to compare the flow-volume loop guided technique for endotracheal tube cuff inflation with the stethoscope-guided technique and to determine whether the flow-volume loop guided technique results in lower and more consistent intracuff pressure.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n The participants were randomized to undergo either the flow-volume loop guided or the stethoscope-guided cuff inflation technique. In the flow-volume loop guided group, the cuff was inflated until the flow-volume loop was completely sealed. In the stethoscope-guided group, the cuff was inflated until the leakage was not audible. Cuff inflation was performed twice with incremental volumes of 0.5 mL and 0.2 mL to determine the consistency of the methods. The primary outcome was the intracuff pressure, and the secondary outcome was the incidence of postextubation complications.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Eighty participants (4 to 12 years old) were included in this study. The use of the flow-volume loop guided technique was associated with a lower cuff pressure versus use of the stethoscope-guided technique when inflated at the 0.5-mL increment [14 (6\u201318) cm H\n 2<\/jats:sub>\n O vs 19 (9\u201324) cm H\n 2<\/jats:sub>\n O;\n P<\/jats:italic>\n \u2009<\u2009.001] and at the 0.2-mL increment [14 (6\u201318) cm H\n 2<\/jats:sub>\n O vs 18 (9\u201324) cm H\n 2<\/jats:sub>\n O;\n P<\/jats:italic>\n \u2009<\u2009.001], with better consistency between the measured cuff pressures (z\u2009=\u2009\u20132.299;\n P<\/jats:italic>\n \u2009=\u2009.02). The presence of postextubation complications (6\/80) was not significantly different between the 2 groups but was associated with the American Society of Anesthesiologists physical status (\n P<\/jats:italic>\n \u2009<\u2009.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The flow-volume loop guided technique for endotracheal tube cuff inflation is a more objective technique that effectively seals the airway with the lower cuff pressure to allow for mechanical ventilation in pediatric subjects during anesthesia.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/respcare.12076","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T10:22:41Z","timestamp":1738578161000},"page":"176-183","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Endotracheal Tube Cuff Inflation Methods in School-Age Children: Flow-Volume Loop-Guided Versus Stethoscope-Guided"],"prefix":"10.1177","volume":"70","author":[{"given":"Witchaya","family":"Supaopaspan","sequence":"first","affiliation":[{"name":"Drs Supaopaspan, Phongdara, and Vijitpavan are affiliated with the Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sawapat","family":"Phongdara","sequence":"additional","affiliation":[{"name":"Drs Supaopaspan, Phongdara, and Vijitpavan are affiliated with the Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amorn","family":"Vijitpavan","sequence":"additional","affiliation":[{"name":"Drs Supaopaspan, Phongdara, and Vijitpavan are affiliated with the Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13281"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318282cc8f"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep290"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198155060-00013"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4103\/1658-354X.136422"},{"issue":"1","key":"e_1_3_2_7_2","first-page":"98","article-title":"A multicenter survey of pediatric endotracheal tube management","volume":"64","author":"Kinoshita M","year":"2015","unstructured":"Kinoshita M, , Shibasaki M, , Shime N, et al. A multicenter survey of pediatric endotracheal tube management. Masui., 2015; 64(1):98\u2013102.","journal-title":"Masui."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2015-309241"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12594"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13311"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2003.12.018"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03016551"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.077651"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2006.02071.x"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e31819d1d99"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-015-2062-4"},{"issue":"11","key":"e_1_3_2_17_2","first-page":"CD011954","article-title":"Cuffed versus uncuffed endotracheal tubes for general anaesthesia in children aged eight years and under","volume":"11","author":"De Orange FA","year":"2017","unstructured":"De Orange FA, , Andrade RG, , Lemos A, , Borges PS, , Figueiroa JN, , Kovatsis PG. Cuffed versus uncuffed endotracheal tubes for general anaesthesia in children aged eight years and under. Cochrane Database Syst Rev., 2017; 11(11):CD011954.","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2005.07.016"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f2ecc7"},{"issue":"6","key":"e_1_3_2_20_2","first-page":"UC01","article-title":"Comparison between two endotracheal tube cuff inflation methods; just-seal vs. stethoscope-guided","volume":"11","author":"Borhazowal R","year":"2017","unstructured":"Borhazowal R, , Harde M, , Bhadade R, , Dave S, , Aswar SG. Comparison between two endotracheal tube cuff inflation methods; just-seal vs. stethoscope-guided. J Clin Diagn Res., 2017; 11(6):UC01\u2013UC03.","journal-title":"J Clin Diagn Res."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000087882.04234.11"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06853.x"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02683"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2004.01316.x"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12437"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-014-9584-4"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/respcare.12076","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12076","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12076","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:36:38Z","timestamp":1777685798000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/respcare.12076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1089\/respcare.12076"],"URL":"https:\/\/doi.org\/10.1089\/respcare.12076","relation":{},"ISSN":["1943-3654","1943-3654"],"issn-type":[{"value":"1943-3654","type":"print"},{"value":"1943-3654","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]}}}