AG CUFFILL, ETT Cuff Pressure Manometer
$38.50
SKU:
MED-HCSCUFF0041
The AG Cuffill ETT Cuff Pressure Manometer is a pocket-sized digital device that both measures and adjusts the cuff pressure of cuffed endotracheal tubes, tracheostomy tubes, and laryngeal mask airways at the bedside. It reads the pressure on a digital display and lets you add or remove air in the same device, so you reach the recommended 20 to 30 cmH2O range without a separate syringe and gauge. It reads to about 2 cmH2O, is FDA 510(k) cleared, and is single-patient use (reusable up to about 100 times, then discarded). Made by Hospitech Respiration and distributed by Medline (part number HCSCUFF0041), it is supplied in the USA by Pacific Biomedical, an authorized distributor of the AG Cuffill.
Why Cuff Pressure Matters:
- The recommended target is 20 to 30 cmH2O, high enough to seal the airway and prevent aspiration, low enough to protect the tracheal lining.
- Above about 30 cmH2O the cuff presses on the tracheal lining and reduces its blood flow, which can cause mucosal injury and, over time, tracheal stenosis, fistula, nerve injury, sore throat, and hoarseness (the 30 cmH2O ceiling traces to Seegobin and van Hasselt, 1984).
- Below about 20 cmH2O the seal fails, letting secretions leak past the cuff into the lungs and raising the risk of ventilator-associated pneumonia, plus loss of delivered tidal volume.
- Cuffs are out of range often. Up to 52% of intubated patients are found outside the therapeutic range.
- Feel is not enough. In an anesthesia quality initiative, checking by finger palpation over-inflated the cuff 59% of the time; adding a manometer cut over-inflation to 27% and post-operative sore throat from 60% to 32%.
- It is worse before transport. In a helicopter EMS study, patients intubated by the referring agency had a mean cuff pressure of 70 cmH2O, with 84% above the recommended maximum.
How the AG Cuffill Works:
- Connect the Cuffill to the cuff's pilot-balloon valve.
- Press the button. The current cuff pressure shows on the digital display.
- Move the plunger to add or remove air until the reading is in the 20 to 30 cmH2O range.
- Disconnect. A small drop of a couple of cmH2O on disconnection is normal, so set toward the upper part of the range if needed.
- It measures and adjusts in one device, so no separate syringe or dial gauge is required.
Cuffill Compared With Other Ways to Manage Cuff Pressure:
| Method | What it gives you | Key limitation |
|---|---|---|
| AG Cuffill (digital syringe) | An exact digital pressure reading and one-device inflate or deflate, single-patient use | Battery powered, about 100 uses per unit |
| Aneroid dial manometer (for example Posey, VBM, Portex) | A pressure reading or an in-range color band | Usually needs a separate syringe to adjust; reusable units need cleaning and recalibration; some carry accuracy cautions |
| Continuous cuff pressure controller | Holds a set pressure automatically and continuously | Costly capital equipment that tethers the patient to a powered unit and is not portable |
| Manual technique (palpation, minimal occlusive volume, minimal leak, fixed volume) | No device needed | Unreliable, landing outside the safe range most of the time; palpation tends to over-inflate |
Air and Ground Transport:
Cuff pressure is not fixed once it is set. Suctioning, repositioning, and coughing all change it, and during air transport the trapped air in the cuff expands as the aircraft climbs, so the pressure rises with altitude. Flight and transport crews should measure and adjust cuff pressure with each change in altitude and at least every 8 to 12 hours, which a pocket-sized device like the Cuffill makes practical anywhere.
Specifications:
| Specification | Detail |
|---|---|
| Manufacturer | Hospitech Respiration, distributed by Medline |
| Part number | HCSCUFF0041 |
| Use | Measure and adjust cuff pressure for cuffed ET tubes, tracheostomy tubes, and LMAs |
| Readout | Digital pressure and volume |
| Range | 0 to 99 cmH2O |
| Accuracy | About 2 cmH2O |
| Capacity / connector | 10 cc, male luer fitting |
| Use life | Single-patient use, up to about 100 uses, no routine calibration |
| Regulatory | FDA 510(k) cleared (K122721), Rx use, MR Unsafe |
Frequently Asked Questions:
What is the normal endotracheal tube cuff pressure?
The recommended target is 20 to 30 cmH2O. That is high enough to seal the airway and prevent aspiration, but low enough to protect the tracheal lining from pressure injury.
Why measure cuff pressure instead of going by feel?
Because feel is unreliable. Estimating by squeezing the pilot balloon over-inflates the cuff more than half the time. In one anesthesia quality initiative, adding a manometer cut over-inflation from 59% to 27% of cases and post-operative sore throat from 60% to 32%.
What happens if cuff pressure is too high?
Above about 30 cmH2O the cuff reduces blood flow to the tracheal lining, which can cause mucosal injury and ulceration and, over time, tracheal stenosis, fistula, or nerve injury, along with sore throat and hoarseness.
What happens if cuff pressure is too low?
Below about 20 cmH2O the seal fails, letting secretions leak past the cuff into the lungs (microaspiration), which raises the risk of ventilator-associated pneumonia, and the ventilator can lose delivered tidal volume.
How often should cuff pressure be checked?
At least every 8 to 12 hours, and whenever something could change it, such as suctioning, repositioning, coughing, or a change in altitude during air transport.
How does the AG Cuffill work?
Connect it to the cuff's pilot-balloon valve and press the button. It shows the current pressure on a digital display. Move the plunger to add or remove air until you reach 20 to 30 cmH2O, then disconnect. It measures and adjusts in one device, so you do not need a separate syringe and gauge.
Does the Cuffill both measure and inflate?
Yes. It reads the cuff pressure and lets you adjust the volume in the same device, unlike dial gauges that only show a value or a color band.
Is the Cuffill single-use or reusable?
It is single-patient use. You can use it up to about 100 times on one patient and then discard it, and it needs no routine calibration.
How accurate is the Cuffill?
It reads to about 2 cmH2O across a 0 to 99 cmH2O range.
Can I use it on a tracheostomy tube or an LMA?
Yes. It works on cuffed endotracheal tubes, tracheostomy tubes, and laryngeal mask airways. Keep ET and trach cuffs at 20 to 30 cmH2O, and follow the device instructions for LMA cuffs, which are commonly kept at or below a 60 cmH2O maximum per the LMA manufacturer.
What is the target cuff pressure for a tracheostomy tube?
The same 20 to 30 cmH2O range applies, to seal the airway without injuring the tracheal wall.
What about cuffed pediatric tubes?
Cuffed pediatric tubes are also kept in the 20 to 30 cmH2O range (some sources use 20 to 25), and many modern pediatric cuffs seal at lower pressures. Follow the tube manufacturer's guidance.
What is minimal occlusive volume (MOV)?
Inflate the cuff until the air leak heard at peak inspiration just stops. It is better than guessing but can still leave the pressure outside the safe range, so confirm with a manometer.
What is minimal leak technique (MLT)?
Inflate to seal, then let out a small amount of air until a slight leak is just audible at peak inspiration. It tends to give lower pressures but can drop below the safe range, so confirm with a manometer.
Does cuff pressure affect ventilator-associated pneumonia?
Yes. When the cuff pressure falls below about 20 cmH2O, secretions can leak past the cuff into the lungs, and keeping the pressure in the 20 to 30 cmH2O range is part of preventing ventilator-associated pneumonia.
Does cuff pressure change at altitude during flight?
Yes. As an aircraft climbs, the trapped air in the cuff expands and the pressure rises, so flight crews should measure and adjust cuff pressure with the change in altitude.
How does the Cuffill compare to a dial (aneroid) manometer?
A dial manometer shows a pressure or a color band and usually needs a separate squeeze bulb or syringe to adjust, and reusable units need cleaning and recalibration. The Cuffill gives an exact digital number and adjusts in the same single-patient device.
How does it compare to a continuous cuff pressure controller?
Continuous controllers hold a set pressure automatically but are costly capital equipment that tether the patient to a powered unit. The Cuffill is a low-cost, pocket-sized spot-check tool you can use at any bedside, in transport, or in the field.
Can I use a blood pressure gauge to check cuff pressure?
No. A blood-pressure gauge is not built for the low cuff-pressure range and reads unreliably. Use a purpose-built cuff pressure manometer.
Is it FDA cleared, and is there anything to know about MRI?
Yes, the AG Cuffill is FDA 510(k) cleared. It is a prescription device for trained clinicians and is MR Unsafe, so keep it out of the MRI room.
What is 20 to 30 cmH2O in mmHg?
About 15 to 22 mmHg (1 cmH2O is roughly 0.74 mmHg). The AG Cuffill reads in cmH2O, the unit used for cuff pressure.
Should cuff pressure be measured and documented?
Yes. Best practice is to measure with a manometer and chart the actual value each shift and after any change, rather than recording that the cuff felt right by hand. The Cuffill gives an exact number you can document.
Why does cuff pressure monitoring matter financially?
A single hospital-acquired ventilator-associated event costs about $47,000 on average (AHRQ), so a low-cost spot check that keeps pressure in range is inexpensive insurance against a costly complication.
Where can I buy it and what is the part number?
Pacific Biomedical stocks the AG Cuffill, Medline part number HCSCUFF0041. Order from this page.
Always follow the device instructions for use and your institution's policy. Supplied by Pacific Biomedical, an authorized distributor of the AG Cuffill.
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AG CUFFILL, ETT Cuff Pressure Manometer MED-HCSCUFF0041 |
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$38.50
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