To minimize tracheal injury from endotracheal cuff inflation, cuff pressures should be kept within which range?

• A. 5-10 mm Hg
• B. 15-20 mm Hg
• C. 20-25 mm Hg
• D. 30-35 mm Hg

Answer: (C)

Keep endotracheal cuff pressure around the mid-20s in mm Hg. The goal is to seal the airway well enough to prevent leaks and aspiration, but not so high that it cuts off blood flow to the tracheal mucosa. When cuff pressure is too high, the mucosal capillaries are compressed, leading to ischemia, ulceration, and potential long-term injury like stenosis. When it's too low, air leaks and aspiration risk increase. Measuring with a cuff manometer and keeping the pressure in this moderate range minimizes tracheal injury while maintaining a reliable seal.