Endotracheal cuff pressure as an index of airway smooth muscle activity: comparison with total lung resistance.

Pressure changes in the cuff of an endotracheal tube (Pcuff) were measured as an index of the tracheal smooth muscle activity and compared with total lung resistance (RL) in anesthetized, paralyzed and artificially ventilated dogs. After obtaining passive pressure-volume relationships of the cuff in situ, we activated the airway smooth muscle by electrical stimulation of the right vagus nerve, intravenous acetylcholine, and airway mechanical stimulation. The responses elicited by vagal stimulation and airway probing affected predominantly the tracheal smooth muscle, whereas acetylcholine administration caused homogeneous responses in Pcuff and RL, suggesting involvement of the smooth muscle of the entire airway. Pcuff cannot represent the whole airway smooth muscle activity, but it is more sensitive than RL for detecting vagally mediated smooth muscle responses. We conclude that the combination of Pcuff and RL may provide a better evaluation of smooth muscle response to various stimuli.