Background: Management of the endotracheal tube cuff pressure is an important part of the 
care given by critical care nurses for critically ill patients. Over-inflation of the endotracheal tube cuff 
can cause serious injury and affects blood flow to tracheal mucosa. Under-inflation may cause air 
leakage which decreases the effect of mechanical ventilation and increases the risk of pulmonary 
aspiration and accidental extubation. Changes in the patient's position can cause variation in 
endotracheal tube cuff pressure. Objective: to identify the relationship between body position and 
endotracheal tube cuff pressures among critically ill patients. Settings: The study was carried out in 
Damanhur Medical National Institute General ICU, and Damanhur Chest Hospital ICU, Egypt.
Subjects: A convenient sample of 75 adults; orally intubated critically ill patients who are newly 
admitted to the previously mentioned ICUs Methods: Patients' endotracheal tube cuff pressure was 
measured at semi-fowler position 45 which was considered the starting position and the cuff pressure 
was adjusted using the minimum occlusive volume technique and the reading was recorded using a 
cuff manometer to be the baseline measurement. Then the body position was changed every two hours 
and the cuff pressure was measured in three different positioned-fowler 30, left lateral, and right 
lateral positions) immediately, 15 minutes, 30 minutes, 1 hour, and 2 hours after each patient's body 
position change. The observed cuff pressures were compared with the basic cuff pressure at the 
starting position. Results: Significant difference was found (P= 0.000) between ETT cuff pressure 
mean scores measured immediately and 15 minutes after different body position changes in relation to 
the baseline measurement. However, a significant difference was found (P= 0.000) only between ETT 
cuff pressure mean scores measured 30 minutes, 1 hour, and 2 hours after body position change to 
semi-fowler and right lateral positions in relation to the baseline measurement. Conclusion: The cuff 
pressure measurements were significantly changed with changing the patients' body positions at 
different timing. Recommendations: Cuff pressure monitoring using a cuff pressure manometer is 
mandatory before and after critically ill patients' body position changes. A protocol for the ETT cuff 
pressure measurement should be developed.