What cuff pressure range is generally considered safe to minimize mucosal injury?

• A. 5-10 cm H2O.
• B. 20-30 cm H2O.
• C. 35-50 cm H2O.
• D. 60-80 cm H2O.

Answer: (B)

Maintaining cuff pressure within a narrow window is essential to seal the airway without injuring the tracheal mucosa. The tracheal mucosa relies on adequate capillary blood flow, and cuff pressures that are too high compress those vessels, causing ischemia that can lead to ulcers, tracheal stenosis, and a sore throat—especially with longer periods of intubation. If the pressure is too low, the seal can be inadequate and there’s a higher risk of microaspiration and ventilator-associated issues. The generally accepted safe range is roughly twenty to thirty centimeters of water. Keeping within this range—ideally around twenty-five cm H2O—balances a reliable seal with preservation of mucosal blood flow. Use a cuff manometer to monitor and adjust as needed, rather than inflating by feel; if a seal is hard to achieve within this range, investigate tube position, cuff type/design, or other factors rather than exceeding the safe limit.