At what inspiratory pressure should an endotracheal tube leak occur in an infant?

At what inspiratory pressure should an endotracheal tube leak occur in an infant?

• A. 5 to 15 cm H2O
• B. 15 to 25 cm H2O
• C. 25 to 35 cm H2O
• D. 35 to 45 cm H2O

Answer: (B)

Infants have small, highly compliant airways, so the cuff seal around an endotracheal tube is achieved with relatively modest inflation. The first audible leak around the tube occurs once airway pressures reach a mid-range level that’s high enough to overcome the cuff seal but not so high as to risk tracheal injury from overinflation. This is why the expected leak happens at a relatively low-to-mid inspiratory pressure in infants. If the leak appeared at a much lower pressure, the seal would be inadequate; if it only stopped leaking at very high pressures, the cuff would be overinflated and could harm the tracheal mucosa.

Infants have small, highly compliant airways, so the cuff seal around an endotracheal tube is achieved with relatively modest inflation. The first audible leak around the tube occurs once airway pressures reach a mid-range level that’s high enough to overcome the cuff seal but not so high as to risk tracheal injury from overinflation. This is why the expected leak happens at a relatively low-to-mid inspiratory pressure in infants. If the leak appeared at a much lower pressure, the seal would be inadequate; if it only stopped leaking at very high pressures, the cuff would be overinflated and could harm the tracheal mucosa.