Estimation of tracheostomy tube cuff pressure by pilot balloon palpation

J Laryngol Otol. 2007 Sep;121(9):869-71. doi: 10.1017/S0022215107005324. Epub 2007 Jan 9.


Two methods can be used to assess the intra-cuff pressure of tracheostomy tubes: digital palpation of the pilot balloon and use of a hand-held manometer. We conducted a telephone survey to determine the prevalence of both methods in intensive care units within 21 teaching hospitals across the United Kingdom. Forty-two per cent of the intensive care units surveyed used a protocol for monitoring cuff pressure with a manometer.A study to compare these two methods, using the manometer as the reference standard, was then carried out. The cuff pressure was correctly estimated in pre-inflated tracheostomy tubes, in a tracheal model, by 61 per cent of a cross-section of intensive care unit and otolaryngology staff.Using pilot balloon palpation is inaccurate and leaves a significant proportion of patients at risk of tracheal injury. We advocate the wider availability of hand-held pressure manometers in intensive care units and the institution of protocols for monitoring cuff pressure for any patient with a tracheostomy tube with an inflated cuff in situ.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Cross-Sectional Studies
  • Double-Blind Method
  • Humans
  • Intensive Care Units
  • Intubation, Intratracheal / instrumentation*
  • Manometry
  • Palpation / methods*
  • Pressure*
  • Reproducibility of Results
  • Trachea
  • Tracheostomy / instrumentation*
  • United Kingdom