{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:35:19Z","timestamp":1787070919866,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>The endotracheal tube (ETT) is commonly used in mechanically ventilated patients to allow for proper ventilation and prevent aspiration of gastropharyngeal contents. Adequate sealing pressures are required to prevent aspiration while being low enough to maintain adequate perfusion of the tracheal mucosa. Multiple techniques exist for inflation of the endotracheal cuff. This study evaluated and compared four different cuff inflation techniques with the primary objective of measuring the volume of air needed to create an effective seal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      After ethical approval and trial registration, 240 patients scheduled for surgery under general endotracheal tube anaesthesia were enroled, and 228 patients were randomised into four groups (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 57 per group). The ETT cuff was inflated with air according to the designated group. The techniques were compared for the volume of air required to achieve an adequate seal, cuff pressure post-intubation and just before extubation, cuff-related complications of sore throat, hoarseness of voice, and cough after extubation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The manual palpation technique had the highest cuff volume, 5.7 mL [interquartile range (IQR): 5.6\u20135.8], and cuff pressure after inflation, 29.5 (IQR: 29.1\u201329.9, cmH\u2082O), whereas the pressure\u2013volume loop (PVL) method had the lowest values [4.3 (IQR: 4.2\u20134.3) mL; 23.0 (IQR 22.7\u201323.4) cmH\u2082O] (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Before extubation, Group 4 (manual palpation) again recorded the highest cuff pressure [31.3 (IQR: 30.9\u201331.8) cmH\u2082O] and cuff volume [6.0 (IQR: 5.9\u20136.1) mL], while the PVL group had the lowest values [24.9 (IQR: 24.6\u201325.2) cmH\u2082O; 4.6 (IQR: 4.6\u20134.7) mL] (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Cuff inflation guided by the PVL method effectively maintained ETT cuff pressures and volumes within acceptable limits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_545_25","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T19:01:21Z","timestamp":1761937281000},"page":"1221-1227","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of pressure\u2013volume loop, inflation to precise pressure, minimum occlusive volume, and manual palpation techniques for inflation of endotracheal tube cuff: A randomised clinical study"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7628-759X","authenticated-orcid":false,"given":"Soumya","family":"Murmu","sequence":"first","affiliation":[{"name":"Senior Resident, Department of Neuroanaesthesiology and Neurocritical Care, Post Graduate Institute of Medical Education and Research, Chandigarh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2898-9645","authenticated-orcid":false,"given":"Jyoti","family":"Sharma","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4989-2997","authenticated-orcid":false,"given":"Mayank","family":"Gupta","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3527-789X","authenticated-orcid":false,"given":"Ruhi","family":"Sharma","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Anaesthesiology, People\u2019s Medical College and Research Centre, Bhopal, Madhya Pradesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2836-7301","authenticated-orcid":false,"given":"Anju","family":"Grewal","sequence":"additional","affiliation":[{"name":"Professor and Head, Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinesh Kumar","family":"Singh","sequence":"additional","affiliation":[{"name":"Executive Director, Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"R2-20260419","first-page":"1","article-title":"Endotracheal tube cuff pressure: An overlooked risk","volume":"25","author":"Al-metwalli","year":"2021","journal-title":"Anaesth Pain Intensive Care"},{"key":"R3-20260419","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1111\/anae.15668","article-title":"Major complications of airway management: A prospective multicentre observational study","volume":"77","author":"Cumberworth","year":"2022","journal-title":"Anaesthesia"},{"key":"R4-20260419","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1017\/S1049023X21000406","article-title":"Endotracheal Tube Cuff Pressure - Comparison of the Two Filling Methods - Simulated Test","volume":"36","author":"Ilczak","year":"2021","journal-title":"Prehosp Disaster Med"},{"key":"R5-20260419","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s10877-020-00501-2","article-title":"Measuring endotracheal tube intracuff pressure: No room for complacency","volume":"35","author":"Kumar","year":"2021","journal-title":"J Clin Monit Comput"},{"key":"R6-20260419","doi-asserted-by":"crossref","first-page":"365","DOI":"10.17085\/apm.20020","article-title":"Does the minimal occlusive volume technique provide adequate endotracheal tube cuff pressure to prevent air leakage?: A prospective, randomized, crossover clinical study","volume":"15","author":"Park","year":"2020","journal-title":"Anesth Pain Med"},{"key":"R7-20260419","doi-asserted-by":"crossref","first-page":"328","DOI":"10.4103\/1658-354X.136422","article-title":"Tracheal tube cuff inflation guided by pressure volume loop closure associated with lower postoperative cuff-related complications: Prospective, randomized clinical trial","volume":"8","author":"Almarakbi","year":"2014","journal-title":"Saudi J Anaesth"},{"key":"R8-20260419","doi-asserted-by":"crossref","first-page":"6","DOI":"10.4103\/2045-9912.310053","article-title":"Evaluation of audible leak versus pressure volume loop closure for polyvinyl chloride cuff and polyurethane microcuff in endotracheal tube inflated with air: A prospective randomized study","volume":"11","author":"Kumar","year":"2021","journal-title":"Med Gas Res"},{"key":"R9-20260419","first-page":"1594829","article-title":"The efficacy of ultrasound-guided superior laryngeal nerve block as an adjuvant to general anesthesia during suspension laryngoscopy vocal cord polypectomy","volume":"2022","author":"Zhou","year":"2022","journal-title":"Evid Based Complement Alternat Med"},{"key":"R10-20260419","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.4187\/respcare.10865","article-title":"Behavior of endotracheal tube cuff pressure during a routine control maneuver with different manometers","volume":"68","author":"Gonzalez","year":"2023","journal-title":"Respir Care"},{"key":"R11-20260419","doi-asserted-by":"crossref","first-page":"5580","DOI":"10.1038\/s41598-023-32704-3","article-title":"Accuracy of pilot balloon palpation for cuff pressure assessment in small versus large sized tubes: A prospective non-randomized observational study","volume":"13","author":"Ban","year":"2023","journal-title":"Sci Rep"},{"key":"R12-20260419","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.15537\/1658-3175.5651","article-title":"Use of pressure volume loop closure to check for endotracheal tube cuff function. Randomized clinical trial","volume":"33","author":"Kaki","year":"2012","journal-title":"Saudi Med J"},{"key":"R13-20260419","doi-asserted-by":"crossref","first-page":"374","DOI":"10.4266\/acc.2021.00024","article-title":"Under or overpressure: An audit of endotracheal cuff pressure monitoring at the tertiary care centre","volume":"36","author":"Viswambharan","year":"2021","journal-title":"Acute Crit Care"},{"key":"R14-20260419","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jopan.2016.09.002","article-title":"Benchmarking the applicability of four methods of endotracheal tube cuff inflation for optimal sealing: A randomized trial","volume":"33","author":"Tsaousi","year":"2018","journal-title":"J Perianesth Nurs"},{"key":"R15-20260419","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s12871-024-02499-5","article-title":"The effect of different endotracheal tube cuff pressure monitoring systems on postoperative sore throat in patients undergoing tracheal intubation: A randomized clinical trial","volume":"24","author":"Zhu","year":"2024","journal-title":"BMC Anesthesiol"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_545_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:38:55Z","timestamp":1787067535000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_545_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":14,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_545_25","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,31]]},"assertion":[{"value":"2025-05-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}