The investigation of initial endotracheal tube cuff pressures in the operating room: a multi-center cross-sectional study in China

Abstract Cuffed endotracheal tubes (ETTs) are widely used in general anesthesia, with recommended cuff pressure (CP) between 20 and 30 cmH 2 O in adults. This multi-center study investigated actual CP management practices across 19 Grade A tertiary hospitals in China, involving 2058 anesthetized patients. The median initial CP measured within 30 min post-intubation was 48 cmH 2 O (IQR 32–70), with only 19% within the recommended range (75.4% > 30 cmH 2 O; 5.6% 30 cmH 2 O) included: age < 60 years, pressure-controlled ventilation, absence of PEEP, ETT internal diameter < 7.0 mm, aminosteroid neuromuscular blocker use, and trainee-performed inflation. These findings highlight widespread challenges in optimal CP management across Chinese tertiary care centers.